Simply Healthcare Plan Lookup Tool

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Precertification Lookup Tool - Simply Healthcare Plans

(3 days ago) WEBThis tool is for outpatient services only. Inpatient services and non-participating providers always require precertification. This tool does not reflect benefits coverage* nor does it …

https://provider.simplyhealthcareplans.com/florida-provider/precertification-lookup

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Find a Doctor Simply Healthcare Simply Healthcare

(8 days ago) WEBThe Pharmacy network and/or provider network may change at any time. You will receive notice when necessary. You may request a hard copy of the Provider/Pharmacy Directory to be mailed to you at any time by …

https://www.simplyhealthcareplans.com/florida-medicare/care/find-a-doctor.html

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Eligibility & Provider Reports - Simply Healthcare Plans

(8 days ago) WEBTo access member reports: From the Availity homepage, select Payer Spaces from the top navigation. Select the health plan. From the Payer Spaces homepage, select the …

https://provider.simplyhealthcareplans.com/florida-provider/eligibility-provider-reports

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Simply Medicaid Plan benefits Simply Healthcare

(6 days ago) WEBWhether it’s 3 a.m. or a Sunday afternoon, health issues come up. That’s why you can always call our 24-hour Nurse HelpLine and speak directly to a nurse. Call 1-844-406 …

https://www.simplyhealthcareplans.com/florida-medicaid/benefits/medicaid-benefits.html

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Provider Resources - Simply Healthcare Plans

(9 days ago) WEBProvider resources. We are committed to supporting you in providing quality care and services to the members in our network. Here you will find frequently used forms, PDFs, …

https://provider.simplyhealthcareplans.com/florida-provider/resources

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Authorization, precertification and referral process reminder

(3 days ago) WEBSimply Healthcare Plans, Inc. is a Managed Care Plan with a Florida Medicaid contract. Clear Health Alliance is a Managed Care Plan with Use the Prior Authorization …

https://provider.simplyhealthcareplans.com/docs/FLFL_CAID_SMH_AuthPrecertandReferralProcessReminder.pdf

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Getting care 24/7 Simply Healthcare

(7 days ago) WEBAttention Enrollees or Parents/Guardian (s) of Enrollees receiving Private Duty Nursing in the home. You can report missed shifts or nursing visits 24 hours a day/7 days a week …

https://www.simplyhealthcareplans.com/florida-medicaid/care/getting-care.html

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Pharmacy Benefits Simply Healthcare

(6 days ago) WEBThey will work with the pharmacy and Simply to review your case and replace the medicines as needed. If you have any questions about your or your child’s pharmacy benefit, call …

https://www.simplyhealthcareplans.com/florida-medicaid/benefits/pharmacy-benefits.html

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Simply Healthcare Plans Providers

(4 days ago) WEBTo determine if pharmacy benefits are payable by Simply Healthcare Plans, Inc., please confirm the requested services are a covered benefit. Questions about members’ …

https://provider.simplyhealthcareplans.com/florida-provider/home

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Referrals - Simply Healthcare Plans

(9 days ago) WEBStatewide Medicaid Managed Care Managed Medical Assistance Directory - Southwest. Florida Healthy Kids (FHK) Referral Directory — North. Florida Healthy Kids (FHK) …

https://provider.simplyhealthcareplans.com/florida-provider/referrals

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Learn about Availity - Simply Healthcare Plans

(Just Now) WEBLearning opportunities. Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. …

https://provider.simplyhealthcareplans.com/florida-provider/learn-about-availity

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Case Management - Simply Healthcare Plans

(4 days ago) WEBIf not, or if they need help contacting their case manager, please have them contact Member Services at 1-855-459-1566. Our case managers may call our members if: …

https://provider.simplyhealthcareplans.com/florida-provider/provider-case-management

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Florida Medicaid - Simply Healthcare plans Simply Healthcare

(4 days ago) WEBCall Member Services at 844-406-2396 (TTY 711) for Florida Medicaid or 877-440-3738 (TTY 711) for Long-Term Care Monday through Friday, 8 a.m. to 7 p.m. Eastern time if …

https://www.simplyhealthcareplans.com/florida-medicaid/home.html

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Utilization management Simply Healthcare

(7 days ago) WEBFollow the steps outlined below to receive coverage for medications requiring prior authorization: If a Prior Authorization is required, ask your doctor to submit the request …

https://www.simplyhealthcareplans.com/florida-medicare/care/utilization-management.html

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Prescription Drug Benefits Simply Healthcare Simply Healthcare

(1 days ago) WEBPrescription Information Tool. CarelonRx is Simply Healthcare's prescription information tool. As our member, you can use the CarelonRx's tool below to view your medication …

https://www.simplyhealthcareplans.com/florida-medicare/care/prescription-drug-benefits.html

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Member Eligibility & Pharmacy - Simply Healthcare Plans

(6 days ago) WEBMember eligibility, panel listings and member reports. Providers can access real-time member eligibility information, member reports and panel listings from the Availity Portal. …

https://medicalpolicy.simplyhealthcareplans.com/florida-provider/member-eligibility-and-pharmacy

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