Proof of medical expenses can be submitted by fax, mail, or in person. Be sure to include your name and case number on medical expenses.
Rule 2: Providers may NOT bill Medicaid beneficiaries for covered services only the allowable co-payments, co-insurance, or deductibles.
Proof of medical expenses can be submitted by fax, mail, or in person. Be sure to include your name and case number on medical expenses.
Sunshine Health utilizes the encounter reporting to evaluate all aspects of quality and utilization management, and it is required by the State of Florida and by Centers for Medicare and Medicaid Services (CMS). A claim is a request for reimbursement either electronically or by paper for any medical service.
The Florida False Claims Act (the “FFCA”) makes it unlawful for any person to: (a) knowingly present or cause to be presented a false or fraudulent claim for payment or approval; (b) knowingly make, use, or cause to be made or used a false record or statement material to a false or fraudulent claim; (c) conspire to ...
To file a health care facility complaint, call (888) 419-3456 / (800) 955-8771 Florida Relay Service (TDD number) or complete the Health Care Facility Complaint Form. Search our FloridaHealthFinder site to see if the facility you have concerns about is one that is regulated by our Agency.
Timely Filing Guidelines Initial Filing: 180 calendar days of the date of service Coordination of Benefits (Sunshine Health as Secondary); 180 calendar days of the date of service or 90 calendar days of the primary payer's determination (whichever is later).
They must complete a 40-hour training course approved by the Florida Department of Elder Affairs and undergo fingerprinting and background checks. Certified Nursing Assistants (CNAs) can provide more extensive hands-on care. CNA certification requires completing a 120-hour training program and passing competency exams.
Paper-Based Florida Caregiver Requirements You must be 18 or older. A high school diploma or its equivalent. Clear criminal background check. Clean DMV records and valid driver's license. Reliable car with valid insurance. Clear health check. Caregiver training/certification (optional)
Answer: Download and complete the application forms on the Health Quality Assurance Licensure Forms on the Agency's website as listed under the heading “Licensure Application and Related Forms”. Each time a renewal licensure application is submitted, all listed forms must be completed.