How is Medicaid eligibility determined in Florida?
Medicaid eligibility is determined by DCF, except for SSI recipients. Individuals who receive SSI are automatically eligible for Medicaid in Florida. Medicaid services are managed by the Agency for Health Care Administration (AHCA). DCF determines eligibility for the following SSI-Related Medicaid Programs:
What happens to Florida Medicaid during a public health emergency?
Until emergency services have arrived, the recipient will remain actively engaged with a KEPRO counselor on the line until services have arrived Florida Medicaid Coverage has been extended until the end of the public health emergency. This means no Medicaid recipient will lose Medicaid eligibility during the public health emergency*.
How long does it take to apply for Medicaid in Florida?
Medicaid application options may include paper applications, online application submissions, and even in-person applications at your local Medicaid office. Florida must respond to regular Medicaid applications in 45 days (up to 90 days for disability applications). If your Medicaid application isn’t approved, you have the right to appeal.
How do I contact Florida Medicaid about the Zika virus?
Contact Florida Medicaid 1-877-254-1055 Your Protections under the Americans with Disabilities Act Information on the Zika Virus Helpful Brochures, Pamphlets, and Other Agency Approved Publications
How do I submit exceptional claims to Florida Medicaid?
Providers must submit exceptional claims, along with the required Exceptional Claim Form, electronically via the Florida Medicaid Secure Web Portal under the Claims panel.
How to get help with Medicaid fee-for-service in Florida?
For Florida Medicaid Management Information System Fiscal Agent DXC Web Portal Training – contact your DXC Field Representative to register. Provider Support provides research and technical support for Medicaid Fee-For-Service claims inquiries and processing issue resolution. For assistance contact 1-877-254-1055.
What does Florida Medicaid contract with a fiscal agent?
Florida Medicaid contracts with a Fiscal Agent for provider enrollment, management of the beneficiary file/records Medicaid Fee-For-Service claims processing and payment. Florida Medicaid contracts with the following entity to perform Prior Authorization/Utilization Management services.
What is Florida KidCare?
Florida KidCare is the state’s children’s health insurance program for uninsured children who meet income and eligibility requirements. The 1998 Legislature created Florida KidCare in response to the passage of Title XXI of the Social Security Act in 1997.
Is chip the same as Florida KidCare?
CHIP is not an entitlement program and the families pay a monthly family premium of $15 or $20 depending on the family’s income. Florida KidCare also includes Medicaid for children. Visit www.floridakidcare.org or call 1-888-540-5437.
When does Florida Medicaid reimburse for out-of-State Emergency Services?
Florida Medicaid reimburses for emergency services provided out-of-state without a referral, or prior authorization, in the following circumstances: An emergency arising from an accident or illness that occurs while the recipient is out-of-state.