Florida Healthy Kids Award
Simply Healthcare Plans, Inc. (Simply) has officially been awarded a Florida Healthy Kids (FHK) statewide contract. Effective January 1, 2020, Simply will offer coverage to FHK-eligible children in all 11 regions, representing 67 counties.
FHK’s mission is to ensure the availability of child-centered health plans that provide comprehensive, quality health care services. The program has a subsidized plan for children ages 5 through the end of age 18 whose families exceed the income eligibility threshold for Medicaid, as well as full-pay options available for those who don’t qualify for subsidized coverage.
The FHK plan is designed specifically with kids in mind and provides children with access to the services they need at each unique stage of growth and development. Health services are delivered through our network of local doctors, specialists, hospitals, pharmacies and other health care providers.
Provider news
The latest articles and announcements on claims filings, products, benefits, administrative updates, new and revised procedures and guidelines, prescription information, and more.
Medicaid/Florida Healthy Kids updates
Expedited Authorization Requests via Availity
Effective June 20, 2022, Simply and CHA will require all expedited service authorization requests be submitted via the Availity web portal.
Provider Survey Invite
We would appreciate you taking part in this quick survey for us to determine what we could do more of, where we fall short, and how we can better collaborate with you to serve our members - your patients.
Important notice: Dermatology services vendor transition to Dermatology Network Solutions
Effective May 1, 2022, Dermatology Network Solutions will be the statewide subcontractor providing dermatology services to Simply and CHA members.
Important notice - Podiatry services provided by Podiatry Network Solutions
Effective May 1, 2022, Podiatry Network Solutions will be the statewide subcontractor providing podiatry services to Simply and CHA members.
Trauma-informed care physicians training
Earn CME/CEU credit by accessing the Trauma Informed Care for Physicians training by June 30, 2022.
Medicare updates
2021 SNP Models of Care Annual Evaluations
Under the Medicare Modernization Act of 2003 (MMA), Congress created a new type of Medicare Advantage coordinated care plan focused on individuals with special needs. Special Needs Plans (SNPs) were allowed to target enrollment to one or more types of special needs individuals identified by Congress as: 1) institutionalized and/or institutionally equivalent; 2) dually eligible; and/or 3) individuals with severe or disabling chronic conditions.
Important notice: Dermatology services vendor transition to Dermatology Network Solutions
Effective May 1, 2022, Dermatology Network Solutions will be the statewide subcontractor providing dermatology services to Simply and CHA members.
Care for Older Adults - Functional Status Assessment (COA) Measurement Year 2021
We would like to take this opportunity to highlight information about the Care for Older Adults – Functional Status Assessment (COA) measure.
Electronic Medical Record Data Feed Bulletin
Providers using EMR technology can seamlessly increase HEDIS® scores via a secure data feed.
Our new relationship with American Specialty Health
Simply and CHA are contracting with American Specialty Health Group, Inc.* (ASH) to provide quality acupuncture and chiropractic services
Reminder: provider incentive for medication reconciliation
Did you know that Simply pays $25 when a member’s medications post-hospital discharge has been reconciled with the current medication list in outpatient medical record?
2020 SNP Models of Care Annual Evaluations
Looking for the secure portal?
Please visit the Availity portal.
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Availity access
The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.
At Availity, you can:
Request Authorizations.
Submit Claims.
Confirm Eligibility.
Don't have an Availity account? Register for free now!
Receive email from Simply
Simply is now sending some bulletins, policy change notifications, prior authorization update information, educational opportunities and more to providers via email.
Featured resources
Pharmacy Information
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Maternal Child Program
When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
Behavioral health provider
We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.
NCQA Health Plan Recognition
The National Committee for Quality Assurance has awarded an accreditation status of Accredited for service and clinical quality that meets the basic requirements of NCQA’s rigorous standards for consumer protection and quality improvement.
NCQA Health Plan Accreditation surveys include rigorous on-site and off-site evaluations of over 60 standards and selected HEDIS® measures. A team of physicians and health plan experts conducts accreditation surveys. A national oversight committee of physicians analyzes the team’s findings and assigns an accreditations level based on the performance of each plan being evaluated to NCQA’s standards.
