Florida Application Service Provider Agreement
Description
How to fill out Application Service Provider Agreement?
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FAQ
Applicant submits an Enrollment Application via the Florida Medicaid Web Portal Online Enrollment Wizard. 2. The Enrollment Application is evaluated based on the enrollment rules. The Agency completes the credential verification process and site visit, when applicable.
Methods to Verify Eligibility Providers may call Provider Services at 1-844-477-8313. Providers are asked to supply the member's name and date of birth or the member's Medicaid identification number and date of birth.
How do I apply? Apply online at mymedicaid-florida.comopen_in_new. From the home page, hover over Provider Services and select ?New Medicaid Providers? under the Enrollment section. If you are a network health care professional for other Florida Medicaid health plans, you only need to submit 1 application.
The Florida Medicaid Provider Agreement is a contractual agreement between healthcare providers and the Florida Agency for Health Care Administration (AHCA) to participate in the Medicaid program in the state of Florida.
Medicaid services in Florida are administered by the Agency for Health Care Administration. Medicaid eligibility in Florida is determined either by the Department of Children and Families (DCF) or the Social Security Administration (for SSI recipients).