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Notices and newsletters

Stay up to date on the latest provider news and helpful information.

2022

December 2022

 

Provider Manuals, Newsletters and Notifications (PDF)

 

HCPCS Codes for Depression Screenings (PDF)

 

Clinical Payment, Coding and Policy Reminders (PDF)

 

Pharmacy and Prescribers Rejections (PDF)

 

Behavioral Health Provider Training Invitation (12/14/2022) (PDF)

 

Emcara Health Partnership (PDF)

 

Maternity Provider Training Invitation (12/7/2022) (PDF)

 

November 2022
 

Dx Gap Advisor Training (11/30/2022) (PDF)

 

CPT Coding Incentive Program Pilot (PDF)

 

Behavioral Health (BH) Training Invite (12/14/2022) (PDF)

 

Availity Webinars Invitation (PDF)
 

HCPCS Codes for Depression Screening (PDF)

Prior Authorization - Propat Website Access (PDF)
 

Provider Manuals, Newsletters and Notifications Information (PDF)
 

Hurricane Ian - Provisions of and Payment for Services Information (PDF)

 

October 2022
 

Donor Human Milk Coverage (PDF)
 

Computed tomography, thorax, low dose for lung cancer screening, w/o contracts materials PA Requirements (PDF)
 

Obstetrical Provider Incentive (PDF)
 

Florida Healthy Kids Copay Waiver (PDF)
 

October Monthly Provider Billing and Claims Training (10/27/2022)
 

New peer-to-peer process (PDF)

 

Minimum wage agreement (PDF)

 

 

September 2022

 

Hurricane Ian prior authorization update (PDF)

 

Hospice updates (PDF)

 

September monthly provider billing and claims training (PDF)

 

Cologuard new PA requirements (PDF)

 

Medicaid provider minimum wage supplemental wage agreement (PDF)

 

HCPCS codes for depression screening (PDF)

 

 

August 2022

 

Claims and encounters front-end edits (PDF)

 

New PA requirements effective 10/1/2022 (PDF)

 

August monthly provider billing and claims training (PDF)

 

Community health workers (CHW) education (PDF)

 

Claims correspondence and requests for appeal, complaints and grievances reminder (PDF)

 

Social determinants of health – Billable and payable Z codes (PDF) 

 

Administrative denials (PDF)

 

 

July 2022

 

Coding update: Guidelines for modifiers 25, 59, XE, XP, XS, XU (PDF)

 

Important policy updates (Effective August 2022) (PDF)

 

July monthly provider billing and claims training (PDF)

 

Post-acute facility placement request process reminder (PDF)

 

 

May 2022

 

Interim clinical considerations: Caring for newcomers from Ukraine (PDF)

 

Improved design of paper remit process (PDF)

 

Prior authorization requirements for spine codes (PDF)

 

Optimization of Medicaid precertification process (PDF)

 

 

April 2022

 

SBIRT Continuing Medical Education (CME) opportunity (PDF)

 

Therapy network of Florida (PDF)

 

April monthly provider billing and claims training (04/27/2022) (PDF)

 

Vaccines and vaccine administration billing guidance use (PDF)

 

 

 

March 2022 

 

Payment policy for respiratory panels (PDF)

 

Service intensity add-ons (SIA) PA requirements (PDF)

 

Covid-19 visits and services (PDF)

 

March behavioral health webinar training (03/30/2022) (PDF)

 

General inpatient hospice process reminder (PDF)

 

Behavioral health authorizations (PDF)

 

 

 

February 2022 

 

February grievance and appeals monthly provider billing and claims training (02/24/2022) (PDF)

 

February behavioral health webinar training (02/23/2022) (PDF)

 

ProgenyHealth neonatal care management — reminder (PDF)

 

Behavioral health integration update (PDF)

 

 

 

January 2022 

 

HCBS provider funding due date reminder (PDF)

 

January Monthly Provider Billing and Claims Training (01/26/2022) (PDF)

 

Policy reminder/update — Early Intervention Services, immunizations, radiology and nuclear medicine services (PDF)

 

ProgenyHealth neonatal care management (PDF)

 

Florida perinatal quality (FPQC) medical education trainings (PDF)

2021

 

December 2021

 

Behavioral health provider update (PDF)

 

New physical health standard prior authorization (PA) request form (PDF)  

 

Process validation update from SNIP level 2 to SNIP level 4 (PDF)  

 

New vendor for paper claims and claims correspondence (effective 2/14/2022) (PDF)  

 

December monthly provider billing and claims training (12/15/2021) (PDF

 

Nursing facility enhanced rate October 2021 through December 2021 (PDF)

 

Claims appeal, complaint and grievance process reminder (PDF)

 

 

 

November 2021 

 

November provider webinar billing and claims training (11/18/2021) (PDF)

 

Paper remit new design (PDF)

 

COVID-19 monoclonal antibody infusions (PDF)

 

HCPCS codes for depression screening reminder (PDF)

 

SBIRT continuing medical education opportunity (PDF)

 

 

 

October 2021 

 

October provider webinar billing and claims training 10/29/2021 (PDF)

 

CPT S9083-global fee urgent care centers (PDF)

 

Skilled nursing facility (SNF) prior authorization update (PDF)

 

 

 

September 2021

 

Obstetrics and gynecology — fetal prenatal genetic testing policy (PDF)

 

September provider webinar billing and claims training (PDF)

 

 

 

August 2021 

 

COVID-19 liberalization policy revision 08/26/2021 (PDF)

 

August provider webinar billing and claims training 08/31/2021 (PDF)

 

Maternity health program — reducing C-section rates (PDF)

 

COVID-19 liberalization policy update (PDF)

 

 

 

July 2021 

 

New HCPCS codes for depression screening reminder (PDF)

 

July provider webinar billing and claims training 07/29/2021 (PDF)

 

 

 

June 2021  

 

Survey — Primary care & behavioral health member coordination of care (PDF)

 

Payment for prenatal obstetrical ultrasound (PDF)

 

June provider webinar billing and claims training 06/30/2021 (PDF) 

 

COVID-19 temporary flexibilities ending July 1, 2021 (PDF)

 

Florida Healthy Kids copayment update effective 07/01/2021 (PDF)

 

Durable medical equipment (DME) and medical supply services (PDF)

 

Online pre-authorization submission update (PDF)

 

Maternal opioid recovery effort (MORE) (PDF)

 

EVV provider webinar training provider webinar billing and claims training (PDF)

 

Prior authorization requirements for J codes (PDF)

 

 

 

May 2021 

 

Provider electronic fund transfer (EFT) and electronic remittance advice (ERA) information (PDF)

 

Florida Healthy Kids copayment extension through 06/30/21 (PDF)

 

Telemedicine requirements provider webinar billing and claims training (PDF)

 

Home health scope of service (PDF)

 

Assisting living facilities (ALF) general overview provider billing and claims training (PDF)

 

Electronic visit verification (EVV) provider webinar billing and claims trainings (PDF)

 

Clinical payment, coding and policy changes effective 05/25/2021 (PDF)

 

Electronic visit verification (EVV) requirements — effective 06/21/2021 (PDF)

 

HCPCS codes for depression screenings reminder (PDF)

 

 

 

April 2021 

 

April 2021 — 2nd monthly provider webinar training (PDF)

 

Optum payment announcement (PDF)

 

Tobacco cessation billing update (PDF)

 

Bacterial urine culture billing guidance CPT 87086, 87088 (PDF)

 

Bill type error ending in 0 (PDF)

 

Florida Healthy Kids copayment extension through 05/31/21 (PDF

 

Provider webinar billing and claims training (04/29/2021) (PDF)

 

COVID-19 PAR and NON-PAR providers vaccine administration billing guidance (PDF)

 

Aetna private duty nursing (PDN) services (PDF)

 

 

 

March 2021 

 

Change HealthCare web connect tool enhancement (PDF)

 

Anesthesia billing modifiers (PDF)

 

Provider webinar billing and claims training — DME (03/31/2021) (PDF)

 

Global obstetric policy — multiple deliveries (PDF)

 

COVID-19 Florida Healthy Kids copayment extension through 04/30/21 (PDF)

 

 

 

February 2021 

 

COVID-19 PCP-telemedicine survey (PDF)

 

DME/HME services rendered form reminder (PDF)

 

Global anesthesia and pain management (PDF)

 

COVID-19 FHK copayment extension (PDF)

 

Assisted living trainings — English (PDF) | Spanish (PDF)

 

Manifestation billing codes (PDF)

 

Provider webinar billing and claims training (2/24/2021) (PDF)

 

New screening tools and resources (PDF)

 

 

 

January 2021 

 

LogistiCare name change announcement (PDF)

 

Interim billing for inpatient hospital services (PDF)

 

COVID-19 Florida Healthy Kids (FHK) extension through 02/28/21 (PDF)

 

Growth hormone criteria change for Florida Healthy Kids (FHK) (PDF)

 

Aetna provider portal transitioning to Availity — email request (PDF)

 

Florida Healthy Kids copayment extension (PDF)

2020

 

December 2020 

 

Aetna provider portal transitioning to Availity (PDF)

 

Providers monthly webinar December training invitation (12/17/2020) (PDF)

 

 

 

November 2020

 

Electronic visit verification (EVV) requirements (PDF)

 

Co-surgeon modifier 62 (PDF)

 

835s and remittance advise discrepancy notice (PDF)

 

Providers monthly webinar November training invitation (11/19/2020) (PDF)

 

 

 

October 2020 

 

Providers monthly webinar October training invitation (10/29/2020) (PDF)

 

Provider enrollment revalidation process restart (PDF)

 

Florida Healthy Kids copayment extension (PDF)

 

DME/HME services rendered form (PDF)

 

New screening tools and resources (PDF)

 

 

 

September 2020 

 

Patient responsibility billing guidelines (PDF)

 

Negative balance — collection remittance new process (PDF)

 

Long-acting reversible contraceptive (LARC) hospital reimbursement (PDF)

 

COVID-19 copayment and authorization extensions (PDF)

 

Adult community support services (PDF)

 

Tellus EVV and Aetna virtual town hall (PDF)

 

 

 

August 2020 

 

New policies update effective date of service 07/28/2020 (PDF)

 

Providers special trainings (PDF)

 

New HCPCS codes for depression screening (PDF)

 

Upcoming claims review information (PDF)

 

COVID-19 copayment and authorization extensions (PDF)

 

Providers monthly webinar August training invitation 08/27/2020 (PDF)

 

Obstetric (OB) prior authorization requirements (PDF)

 

 

 

July 2020

 

Prior authorization process for custodial care and skilled nursing facility (PDF)

 

Florida Healthy Kids and Medikids immunizations update (PDF)

 

Polymerase chain reaction testing policy (PDF)

 

Home and community-based provider retainer payment limitations (PDF)

 

Providers monthly webinar July training invitation (07/30/2020) (PDF)

 

New website pharmacy updates (PDF)

 

COVID-19 waiver of prior authorization requirements for hospital transfers (PDF)

 

COVID-19 prior authorization reinstatement process for home health & DME services (PDF)

 

COVID-19 prior authorization reinstatement effective 06/19/2020 (PDF)

 

 

 

June 2020 

 

Personal protective equipment policy reminder (PDF)

 

Providers monthly June webinar training invitation (06/25/2020) (PDF)

 

Provider relief funding information (PDF)

 

Inpatient diagnosis related group (DRG) adjustments (PDF)

 

 

 

May 2020 

 

Prior authorization (PA) changes for 2020 (PDF)

 

COVID-19 extended benefits information (PDF)

 

Providers webinar training invitation (05/28/2020) (PDF)

 

COVID-19 members Medicaid eligibility benefits (PDF)

 

TL modifier clarification for early intervention therapy services (EIS) (PDF)

 

COVID-19 pandemic impact questionnaire (PDF)

 

 

 

April 2020 

 

Obstetric (OB) ultrasounds codes and limits requirements (PDF)

 

COVID-19 electronic visit verification (EVV) requirements (PDF)

 

Florida Healthy Kids COVID-19 copayment waiver (PDF)

 

 

 

March 2020 

 

Removal of authorization requirement for observation level of care (PDF)

 

Providers webinar invitation — FHK and MMA billing and claims training (PDF)

 

NEW early intervention services (EIS) prior authorization and modifier requirement (PDF)

 

COVID-19 telemedicine guidance (PDF)

 

COVID-19 prior authorization requirements (PDF)

 

COVID-19 home health agency (HHA) provider survey (PDF)

 

Providers webinar invitation — billing and claims training (PDF)

 

Member rights and responsibilities (PDF)

 

New review process for sterilization codes (PDF)

 

 

 

February 2020 

 

Allergy testing policy reminder (PDF)

 

Grievance and appeals address change effective 03/01/2020 (PDF)

 

Orthotics and prosthetics prior authorization requirements (PDF)

 

Billing hospital-based urgent care services (PDF)

 

Changes to prior authorization for diabetic supplies (PDF)

 

Home health services coding and billing guidelines (PDF)

 

 

 

January 2020 

 

Medicaid inpatient/observation notifications and authorizations (PDF)

 

HCPCS Code J3145 prior authorization changes (PDF)

 

Neuropsychological/psychological testing prior authorization changes (PDF)

 

Prior authorization for custodial and skilled SNF provider (PDF)

 

Expanded benefits suppliers (PDF)

 

EVV update provider notification (PDF)

 

Behavioral/mental health vendor clarification (PDF)

 

Value-added benefits for Florida Healthy Kids (FHK) members (PDF)

 

Florida Healthy Kids (FHK) primary care physician (PCP) assignments information (PDF)

 

Provider manual (PDF)

 

 

2019

 

December 2019

 

Florida Healthy Kids provider webinar (PDF)

 

Florida Healthy Kids continuity of care provider notification (PDF)  

 

Electronic visit verification (EVV) implementation update (PDF)  

 

Pediatric oncology clinical review process (Eviti)

 

 

 

November 2019 

 

Florida Healthy Kids town hall (region 4) (PDF)

 

Housing assistance pilot program (region 7) (PDF)

 

 

 

October 2019 

 

Project ECHO (PDF)

 

Behavioral health provider trainings (PDF)

 

New prior authorization form (PDF)

 

Pharmacy network changes (PDF)

 

 

 

September 2019 

 

Integrated care management (PDF)

 

Florida Healthy Kids contract announcement (PDF)

 

 

 

August 2019 

 

Electronic visit verification (EVV) solution implementation (PDF)

 

Remit advice and provider web portal education (PDF)

 

 

 

July 2019 

 

HEDIS coding well and sick visits (PDF)

 

Pharmacy network update (PDF)

 

 

 

June 2019 

 

Prior authorizations — custodial and SNF education (PDF)

 

Aetna Better Health of Florida payer ID information (PDF)

 

 

 

May 2019 

 

Abuse, neglect, and exploitation provider training (ANE) (PDF)

 

 

April 2019  

 

Unlisted and non-specific codes education provider communication (PDF)

 

Evaluation and management (EM) information (PDF)

 

OB updates (PDF)

 

Refund checks reminder (PDF)

 

 

 

March 2019 

 

Authorizations fax number information (PDF)

 

 

 

February 2019 

 

Therapy vendor update (PDF)

 

 

 

January 2019 

 

Enhanced ambulatory patient groupings (EAPG) (PDF)

 

NPI Medicaid ID billing requirements (C85) (PDF)

 

Provider satisfaction survey (PDF)

 

 

2018

 

December 2018  

 

Continuity of care (COC) information (PDF)

 

Participating vendors list (PDF)

 

 

 

November 2018

 

Early Intervention Services therapy approval process (PDF)

 

Covered flu vaccines (PDF) 

 

 

 

October 2018 

 

Home health and personal care services billing (PDF)

 

MediKids vaccine information — Children’s Health Insurance Program (CHIP) (PDF)

 

Hospice guidelines (PDF)

 

Non-emergency medical transportation changes (PDF)

 

Hurricane Michael (PDF)

 

 

 

September 2018 

 

Anesthesia billing modifiers (PDF)

 

Integrated care management programs (PDF)

 

 

 

July 2018 

 

Recoupment project information (PDF)

 

Urine drug testing (UDT) (PDF)

 

No prior authorization required on select X-rays and ultrasounds (PDF)

 

 

 

May 2018 

 

MCNA preventive dental benefits outreach (PDF)

 

E&M coding edits (PDF

 

Aetna assistance program — Marjory Stoneman Douglas HS (PDF)

 

Enhanced ambulatory patient groupings (EAPG) physician notification (PDF)

 

Event notification service (ENS) participation (PDF)

 

January capitation payment delay (PDF)

 

National drug code NDC (PDF)

 

Oncology pre-certification process (PDF)

 

Preferred home health agency (PDF)

 

Revised — national drug code (NDC) (PDF)

 

Risk adjustment letter (PDF) 

 

 

 

January 2018 

 

New updates bulletin v.2 (PDF)

 

Clinical payment, coding and policy changes (PDF)

 

Prior authorization requirements (PDF) 

 

eviCore fax blast (PDF)

 

MCNA pregnant woman outreach fax blast (PDF)

 

MCNA preventive dental benefits outreach (PDF)

 

Medicaid and FHK prior authorization requirements (PDF)

 

 

 

 

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