Sunshine health transportation

Sunshine health transportation. Sunshine Health (Medicaid) members speak more than 15 languages. This includes the member handbook, forms, and more. This includes verifying the member’s eligibility, trip purpose and mode of transportation. Learn how to schedule, cancel, or change a ride, and what other transportation benefits are available. 24-Hour Behavioral Health Crisis Line If you are having a behavioral health crisis, call us for help at 1-866-796-0530 (TTY 1-800-955-8770 ). Press 2 for LTC or 3 for MMA. The following transportation services Autism Spectrum Disorder is a common developmental condition that affects the brain. Apply for Medicaid. No results were found. Ambetter from Sunshine: 1-866-417-0298. Each date of service must have a physician or clinician signature. If you have an urgent medical situation please contact your doctor. POLICY AND PROCEDURE . We also provide telemedicine options to offer members live LOAP/Practitioner Roster Form (Excel). com. If you need a ride to any of these services, we can help you. Ambetter Bronze, Silver and Gold. Evidence-based screening tools can assist primary care providers in Mar 31, 2024 · Our MAPD plans offer affordable coverage beyond Original Medicare, including a range of benefits such as dental, hearing and vision services; prescription drug services; Flex Cards; transportation services; telehealth visits; wellness programs; in-home support services; and special supplemental benefits for the chronically ill. Transportation Management (MTM) CMS 1-877-583-1554 Monday-Friday from 8 a. Census data. Additions only. Eastern . Prior Authorization for medical necessity We believe local partnerships enable meaningful, accessible healthcare. If there are changes in covered services or other changes that will affect you, we will notify you in writing at least 30 days before the effective date of the change. There may be some services that we do not cover, but might still be covered by Medicaid. If you are eligible for Florida Medicaid, the Agency for Health Care Administration (AHCA) will send you a letter asking you to choose a plan. Medicaid 877-659-8421/ TTY: 711 Child Welfare 877-659-8421/ TTY: 711 Long Term Care 877-659-8415/ TTY: 711 • Please make a reservation with an estimated pick up time in order to avoid wait times associated with Will Calls. Ambetter from Sunshine Health does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. It affects 1 in 36 children in the United States. REVISED policies, effective January 1, 2022, for Medicaid, Marketplace (Ambetter), and Medicare (Wellcare by Allwell) lines of business: RETIRED policies, effective January 1, 2022 for Medicaid What transportation services will LogistiCare provide Medicaid, Long Term Care and Child Welfare members? LogistiCare will serve as Sunshine Health’s administrator for all non-emergent transportation operations. Providers and practitioners have the right to review any primary source information that Sunshine Health collects during this process such as the National Practitioner Data Bank (NPDB), Licensing and Sunshine Health offers many convenient and secure tools to assist you. The following services are excluded: . Call the 24-hour Sunshine Health Nurse Advice Line. To help your child get healthy and stay healthy, we can provide rides to your child’s medical appointments at no cost to you. Date: 02/20/24 Fort Lauderdale, Florida. If you would like help finding a new primary care provider for your child, please call their care manager or Member Services at 1-866-799-5321 (TYY 1-800-955-8770 ), or use our Find a Provider Tool . If your child needs a ride to any of these services, we can help. org. to 8 p. 1. FL. to 6 p. Because protecting peoples’ health is why we’re here, and it’s what we’ll always do. Login, enroll or find a doctor today. Many Care Options for Minor Injuries. To find out about these benefits, call the Agency Medicaid Help Line at 1-877-254-1055. Mail a home delivery order form. Ambetter: 1-833-750-1160. Learn more. There are many ways to get in touch with us, and resources available on our website: Enroll with Ambetter Health. Louis, MO 63367. Remember, services must be medically necessary in order for us to pay for them. Feb 21, 2024 · Our Utilization Management Department is available Monday through Friday from 8 a. Sunshine Medical Transport drivers will serve you door to door with no shared rides. Providers may call Provider Services at 1-844 Sunshine Health’s Community Resource Database can connect you with local, community-based services like transportation, food and childcare. Benefits Overview. serves: Managed Medical Assistance (MMA), Serious Mental Illness Specialty Plan Modivcare maintains a Facility Department dedicated to handling the needs of nursing homes, hospitals, dialysis centers, mental health facilities, and other healthcare providers. Centene Corporation is a leading healthcare enterprise committed to helping Don't Forget to Renew Each Year. The following services are excluded: Non-emergency transportation – non-medical purposes. Or choose Virtual 24/7 Care * for convenient video doctor visits! If you can’t wait for an appointment with your PCP, visit an urgent care center for injuries During the credentialing and re-credentialing process, Sunshine Health will obtain information from various sources to evaluate applications. 56_ Non-Emergency Transportation Services Page 1 of 2 . Referrals to local, community-based partners. You can call us at any time, even after business hours, to reach our 24-hour Nurse Advice Line. Call: 1-866-796-0530 (TTY: 1-800-955-8770) Monday to Friday, 8 a. Members also have access to Krames Staywell Health Library which accesses more than 4,000 health topics in a searchable database. The Sunshine Health utilization management program serves to: Ensure confidentiality of personal health information. BUSINESS UNIT: Sunshine State Health Plan. Visit the Florida Department of Children and Families to sign up for email reminders. The program also helps members manage chronic conditions and build relationships with their providers. ” An appeal is a request to review a Notice of Action. Each log must be filled out completely to qualify for reimbursement, including a trip date, medical provider name and phone number, physician/clinician signature, and total number of miles driven associated with that particular visit. In this section, we provide information, education and resources. You can login or register. Transportation Services Chronic Conditions ADHD Anxiety Asthma Bipolar Disorder Sunshine Health is a managed care plan with a Florida Medicaid contract. Sunshine Health’s Community Resource Database can connect you with local, community-based services like transportation, food and childcare. Choose or change your provider in your private, online account. Sunshine Health wants to fully solve your problems or concerns. Grievance and Appeals. There are no limits to the number of trips during the year between medical appointments, healthcare facilities or pharmacies. One-on-one support to develop a plan to achieve economic-self sufficiency. Contact your child’s Care Manager’s supervisor. P. For questions on advanced imaging, call 1-866-214-2569. Trips over 100 miles one-way and out of the service areas/state require prior authorization, which LogistiCare will request from Sunshine Health’s Utilization Management department. Ancillary MMA/SMI/CW Including Home Health, PDN (PDF) Sunshine Health is a managed care plan with a Florida Medicaid contract. Medicaid 877-659-8420/TTY: 711 877-659-8421/TTY: 711 Child Welfare 877-659-8420/TTY: 711 877-659-8421/TTY: 711 Long Term Care 877-659-8414/TTY: 711 877-659-8415/TTY: 711 • Mileage reimbursement trips may be scheduledup to 30 days in advance but no later than the day of the appointment. 3. Find a provider today. External Link. If you need to connect with a Hope Navigator, call the Hope Line at 1-850-300-HOPE ( 1-850-300-4673 ). 1-866-796-0530 ( TTY 1-800-955-8770) FIND A PROVIDER. If you need help understanding any of the information, please call us at 1-855-463-4100 (TTY 1-800-955 Benefits Ambulance Transportation Services: Ambulance services are for when you need emergency care while being transported to the hospital or Sunshine Health offers affordable Florida Medicaid, Medicare Plans and our Health Insurance Marketplace product, Ambetter. 56. Visit Sunshine Health Member Services. Ask about next steps and schedule a follow-up appointment, if needed. Nurse Advice Line staff are available 24/7 for after-hour calls. You may call us at 1-866-796-0530, or TTY at 1-800-955-8770, Monday through Friday, 8 a. (Medicaid, Child Welfare Specialty Plan, Long Term Care, Serious Mental Illness, Children's Medical Services Health Plan) 1-866-477-6725. Sunshine Transit provides Inexpensive, reliable transportation and breaks down barriers to healthcare, wellness, education, and employment in the Upper Susitna Valley. ModivCare provides transportation for Child Welfare Specialty Plan members. To help you get healthy and stay healthy, we can provide rides to your medical appointments at no cost to you. Sunshine Health also offers a Community Resource Database that connects members to services and community resources like finance, transportation, housing. Initiate process improvement activities to enhance utilization management practices. If you have any questions, we’re here to help Monday through Friday, 8 a. Serious Mental Illness Specialty Plan Member Sunshine Health Plan Reservations Ride Assistance . Overview To meet our members’ unique needs, Sunshine Health has three transportation vendors by line of business: • Modivcare. Members ages 0-2 years old are managed by Sunshine Health. Box 459087. Some covered services require a prior authorization from Sunshine Health before the service is provided. Call Us Sunshine Health Plan Ride Assistance . If you have a life threatening emergency, please contact 911. This includes your Member Handbook, forms and more. Sunshine Health Member Services. PRODUCT(S): Managed Medical Assistance (MMA), Please fill out the below form or contact us at 1-866-796-0530 . We would like to show you a description here but the site won’t allow us. UM. Ambetter from Sunshine Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Applied Behavioral Analysis (CMS Title 21 Only) Supervising Board Certified Behavior Analyst (BCBA) provider: Name, credentials, NPI/TIN & affiliated agency NPI/TIN. Blue Cross Blue Shield: 1-855-875-5194. Please do not submit a full roster. Sunshine Health is a Florida Medicaid health plan and a wholly-owned subsidiary of Centene Corporation, a leading multi-line healthcare enterprise offering both core Medicaid and specialty services. Chemotherapy/Radiation. Go to the Benefit Menu, click Forms, and download the Home Delivery Order Form. We have dedicated staff and phone numbers available to book transportation for facilities. abhinfo@bhcpns. 1-844-477-8313. Hospital Admission/ Discharge. Sunshine Health understands that mental health is key to overall health. To find out about these benefits, call the state Medicaid Help Line at 1-877-254-1055. at 1-866-796-0530, during normal working days. For more information on the Complaints, Grievances and Appeals Process please refer to the Member Handbook (PDF). Trips over 100 miles one-way and out of the service areas/state require prior authorization, which ModivCare will request from Sunshine Health’s Utilization Management department. Sunshine Health contracts with the following vendors for service: ModivCare. For a list of items, check out Pharmacy. Our Serious Mental Illness Speciality Plan (SMI) focuses on whole health, with benefits and services designed to support physical and mental health. These tables list the services covered by our Plan. Nursing Homes. NCIL is the longest-running national cross-disability, grassroots organization run by and for people with disabilities. It can cause social, communication and behavioral challenges. Three round trips per month. Discover job opportunities with Sunshine Health Works. Visit the Florida Department of Children and Families website to apply for Florida Medicaid. Required fields are marked with an asterisk (*) Member Transportation Services. POLICY NAME: Non-Emergency Transportation Services. There are no limits to the number of trips during the year between medical • Sunshine Health: 1 -888 863 0248 (TTY 711) • Staywell: 1-888-863-0249 (TTY 711) • Transportation support and discharges 24 hours a day • Alivi secure portal (Please note: the above is for providers to schedule/book trips). Transportation for non-medical trips, such as shopping or social events. POLICY ID: FL. Billing and Claims. About Our Plans. S. New Ambetter Health Members – Set up your Online Member Account. Our Transition Aged Youth Program Covers: Over-the-Counter medication/supplies to help with personal hygiene, sexual health, first aid and more with a $25 monthly allowance. We look forward to serving you. Children's Medical Services Health Plan: 1-833-705-1351. A new window will open. Ambetter Health offers Marketplace insurance plans with different coverage and benefit options, and premium levels. This is your easy, 24-hour access to in-network providers for non-emergency health issues. Cigna Healthcare Medicare Advantage - South Florida (Southwest, Treasure Coast): ENROLLING AND CHOOSING SUNSHINE HEALTH IS EASY. Sunshine Health, a wholly-owned subsidiary of Centene Corporation (NYSE: CNC), is proud to announce the latest winners of their Community Connections Grants, which support nonprofit community organizations across Florida. Get rewarded for focusing on your health during pregnancy! Earn My Health Pays® rewards when you complete healthy activities like annual screenings, tests and other ways to protect your health. If you need help understanding any of the information, please call us at 1-866-796-0530 ( TDD/TTY 1-800-955-8770 ). You can get easy access to a doctor when you want to see one. NCIL provides technical assistance to Sunshine Health and helps coordinate a local BRF Committee that Contacting Member Services. Receive a letter to choose a plan. m. 1-866-796-0530 (TTY 1-800-955-8770) Press 1 for Member. For questions on the formulary or a drug that is provided through a retail pharmacy or specialty pharmacy call. Authorization to Use and Disclose Health Information Notice to Member: Member Resources. Existing Ambetter Health Members Don’t be embarrassed to talk about your health issues or symptoms. The phone number is 1-866-252-1566. to 7 p. Medicaid and Child Welfare Specialty Plan Member Reservations: 1-877-659-8420. Dec 2, 2021 · The changes outlined below will reduce the administrative burden on you and your office, making it easier for you to work with Sunshine Health. Sunshine Health oversees the Musculoskeletal Surgical Quality and Safety Management Program and is responsible for claims adjudication. Top 10 Best Sunshine Medical Transportation in Los Angeles, CA - June 2024 - Yelp - Sunshine Medical Transport, Sunshine Accessibility, Sunshine Rideshare, Rae of Sunshine Professional Home Care, A Sunshine Deluxe Transportation, Sunshine Medical Equipment, Beverly Hills Surgical Aftercare, Hilltop Colony Hoa, State & Liberty West Hollywood Member Transportation Services. 2% prefer Spanish according to U. Learn more about our plan options, including Ambetter Select, Ambetter Value and Ambetter Virtual Access plans! Find the Ambetter Health plan that works best for you. Find out if you need a Medicaid pre-authorization with Sunshine Health's easy pre-authorization check. O. If you have questions about any of the covered medical services, please call your child’s care manager There may be some services that we do not cover, but might still be covered by Medicaid. Dialysis Appointments. Please call MTM at 1-844-399-9469 to A session will be held on June 27, 2024, from 1:30 to 4 p. Behavioral health providers and referrals to them, as needed, play an essential role in providing this integrated care. We offer local and long distance transport services including but not limited to: Medical/Dental Appointments. If your injury is minor and not life threatening (like a sprain or a cold), your first choice should be to call your primary care provider (PCP). People with autism often move, learn and process emotions differently. Treatment plan including symptoms/behaviors requiring treatment (as indicated by assessment tool) Services offered by Hope Navigators: Identifying goals and barriers. The list of services that need a prior authorization can include an admission to the hospital after your emergency condition has improved, power wheelchairs, home health visits, MRI X-rays, hospice care, genetic Jul 1, 2023 · Sunshine Health’s Healthy Behaviors program aims to help members improve their health and wellness. Sunshine Health has contracted with the following vendors for service: Access Behavioral Health. Press 5 for Nurse Apr 10, 2024 · Sunshine Health is proud to partner with the National Council on Independent Living (NCIL) on the administration of the BRF. If you would like help finding a new primary care provider, call Member Services at 1-866-796-0530, or use our Find a Provider Tool . TNFL administers therapy services at outpatient free standing facilities for Sunshine Health’s Medicaid (MMA), Serious Mental Illness (SMI) Specialty Plan and Child Welfare (CW) Specialty Plan members ages 3 years and above enrolled in Sunshine Health. Cigna Healthcare Medicare Advantage - Central Florida (Daytona, Jacksonville, Orlando, Tampa) : 1-866-214-5126. Email: Sunshine_Appeals@centene. Alivi Transportation, guidelines for eligibility and submission for mileage reimbursement and the appropriate level of need of members Sunshine Health. There are no limits to the number of trips that you may schedule during the year to take you to medical appointments, healthcare facilities or pharmacies. Round-trip transportation three times a month to social activities and places like work, post-secondary school and more. If there are changes in covered services or other changes that will affect you, we will notify you in writing at least 30 days before the effective Sunshine Health focuses on a comprehensive approach to care for our members, which includes a combination of physical and behavioral health services. By creating a Sunshine Health account, you can: Change your Primary Care Doctor. When you call, make sure you have your identification card (ID card) with you so we can help you. Sunshine Health exists to improve the health of its beneficiaries through focused, compassionate and coordinated care. Transition Assistance – Nursing facility to community setting. The program includes management of non-emergent, high-tech, outpatient radiology services through prior authorization. Search Results for: The maximum number of characters in a search is 60. This program is consistent with industry-wide efforts to ensure clinically appropriate quality of care and to manage the Call Express Scripts at 1-833-750-4300 (TTY 1- 800-899-2114 ). A Sunshine Health representative may contact you regarding your inquiry. In 2022, 73. If there are changes in covered services or other changes Write us or call us within 60 days of our decision about the services. Get medical advice, a diagnosis or a prescription. Ambetter, Medicaid, Serious Mental Illness and Child Welfare: 1-800-460-8988. No. Comprehensive Long Term Care members receive Medicaid benefits and Long Term Care benefits. The QRGs include targeted claims and authorization instructions per provider type. Please call MTM at 1-844-399-9469 to schedule a ride at no cost to you. The transportation has up to 60 minutes from the time of the call to pick up member, and 3 hours for unscheduled trips. Use Your My Health Pays rewards to help pay for: Utilities; Transportation; Telecommunications; Childcare services; Education; Rent; Or you can use Ambetter Health can help. Centene Corporation is a leading healthcare enterprise committed to helping 16 Hawk Ridge Drive. We urge all providers to utilize the prior authorization form alongside the dedicated fax line for DME/HHC Inpatient Discharge requests. Serious Mental Illness Specialty Plan Member Get Rides to Medical Appointments – At No Cost to You. Sunshine Health offers free rides to medical appointments for its members enrolled in Children's Medical Services Health Plan. If there are changes in covered services or other changes The transportation has up to 60 minutes from the time of the call to pick up member, and 3 hours for unscheduled trips. To make it easy for you to get healthy and stay healthy, Sunshine Health provides rides to your medical appointments at no cost to you. Jan 1, 2024 · You can call 1-866-799-5321 (TTY 1-800-955-8770) Monday through Friday 8 a. We will help you. Physical Therapy. Phone: 1-866-799-5321 (TTY 1-800-955-8770) Fax: 1-866-534-5972. If you need help understanding any of the information, please call Member Services at 1-866-799-5321 (TYY 1-800-955-8770) or your child’s care manager. The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for our members. Your inquiry will be reviewed. Service Type. Sunshine Health offers telehealth services at no cost to you. Learn how to enroll in Medicaid health plans through Sunshine Health online and sign up for Medicaid in Florida with Sunshine Health. Lake St. Sunshine Health provides affordable health insurance plans and is one of the largest Florida Medicaid providers. Sunshine Health has contracted with the Florida Agency for Health Care Administration (AHCA) to serve Medicaid, Comprehensive Long-Term Care, and other program members. This includes a member handbook, forms and more. It has a wide range of symptoms that can vary from person to person. EFFECTIVE DATE: 07/11/2022. Feb 20, 2024 · Sunshine Health Offers $200,000 in Grants to 53 Florida Nonprofits. Disclosure of Ownership Form (PDF) Disclosure of Ownership Form (PDF) - facilities. FUNCTIONAL AREA: Utilization Management. Please see the Provider Billing Manual and Billing Quick Reference Guides (QRGs). To get a copy of the form, register or log in. Sunshine Health has been serving Florida since 2009 and currently serves more than 1 million members across its Medicare, Medicaid and Marketplace plans. Don’t wait for an in-person visit. The guides detail billing guidelines, duplicate billing, corrected claims processes and many more topics. ModivCare provides transportation for Sunshine Health Medicaid members. Make evidence-based decisions that take into consideration medical necessity, appropriateness and availability of benefits. • Schedule and check the status of trips using a member mobile app for iOS and Android users. A grievance is an expression of dissatisfaction about any matter other than an “action. Login to the Secure Member Portal. Sunshine Health is committed to providing our members with the resources they need to get the best care possible. Fort Lauderdale, FL 33345-9087. The benefit information provided is a brief summary, not a complete description of benefits. Express Scripts can contact your doctor for a new prescription to be filled at mail order. 1% of Florida residents reported English as their preferred language, and 23. Last Updated: 02/21/2024. Read the full 2022-2023 evaluation (PDF). In this section, we provide information and resources. Call Provider Services at 1-844-477-8313 or Fax 1-866-614-4955 with questions about claims, credentialing or network status. If there are changes in covered services or other changes that will affect you, we will notify you in In this section, we provide information, education and resources. Using the portal, any registered provider is able to quickly check member eligibility by indicating the date of service, member name, and date of birth or the Medicaid ID number and date of birth. The Jan 1, 2024 · Sunshine Health offers affordable Florida Medicaid, Medicare Plans and our Health Insurance Marketplace product, Ambetter. Creating an account is free and easy. Sunshine Health offers affordable Florida Medicaid, Medicare Plans and our Health Insurance Marketplace product, Ambetter. Call Member Servicesat 1-866- 799-5321 (TTY1-800-955-8770) Children's Medical Services Health Plan Medicaid Webpage. Mental health issues affect 1 in 6 adults in Florida. You can contact us at: Children’s Medical Services Health Plan. You can count on us to share helpful information about COVID, how to prevent it, and recognize its symptoms. If you need help finding an in-network provider, please call Member Services at the number on the back of your ID card. Known as My Health Pays, the program lets members earn dollar rewards by completing healthy activities. 84% of Sunshine Health members reported English as their preferred language and 15% preferred Spanish. CMS Health Plan might not cover some services, but Medicaid might still cover them. Recertify your Medicaid coverage every 12 months to keep your benefits. Cigna Healthcare Medicare Advantage - North Florida: 1-866-214-5126. Things like paying your cellphone bill, rent and more though To find out about these benefits, call the Agency Medicaid Help Line at 1-877-254-1055. Services must be medically necessary in order for us to pay for them. , but not on state approved holidays (like Christmas Day and Thanksgiving Day). • Will Call expected response time is 5 to 90 minutes. You can call 1-877-659-8420 to schedule a ride. Searching for affordable health insurance in Florida? Ambetter from Sunshine Health offers quality coverage for any Feb 23, 2021 · Amid the ongoing COVID-19 pandemic, Ambetter from Sunshine Health also covers the cost of COVID-19 tests and the associated physician’s visit when medically appropriate. The number is 1-866-796-0530. Box 459089 Fort Lauderdale, FL 33345-9089. Sunshine Health is committed to providing our Members with the resources they need to ensure the best possible care. OTR Tips. Eastern. Your doctor is there to help. Do it all by phone or video. Sunshine Health has contracted with Evolent* for radiology and cardiac imaging benefit management. Children’s Medical Services Health Plan is a plan for children and youth less than 21 with serious, chronic conditions. Gurney Transportation. Clinical information to include with OTR. Provider Services. Financial assistance to members residing in a nursing home who can transfer to independent living The doctor is there to help. Eastern Saturday 8 a. Don’t forget, helpful tools can also be accessed through the CMS Health You can also reach us from 8am-8pm EST at 1-877-687-1169 ( Relay Florida 1-800-955-8770 ). Medicaid and Child Welfare Specialty Plan Members Ride Assist (Where’s My Ride): 1-877-659-8421. If you lose your ID card, or if it is Providers are asked to verify member eligibility by using the Sunshine Health secure provider portal. BENEFITS & SERVICES. To enter our secure portal, click on the login button. Limitations, co-payments and restrictions may apply. You also have access to your healthcare information. Get covered with Sunshine Health today. Ages 18 and older. If you don’t know who your child’s care manager’s supervisor is, call Member Services at 1-866-796-0530 (TTY 1-800-955-8770 ). 2. We believe local partnerships enable meaningful, accessible healthcare. to 5 p. wg ke jq nd vt si xa hf un fr