Hurricane Dorian Notices and Updates

UPDATE: Hurricane Dorian – Key Medicaid Information for
Fee-For-Service and Managed Care Providers


The purpose of this alert is to provide an update to the previous provider alert issued on 8/30/2019 regarding Hurricane Dorian.

Now that the hurricane has moved past Florida and we begin returning to normal business operations, the following flexibilities/waivers offered to providers in the alert issued on 8/30/2019 will expire at 11 :59 p.m. on Sunday, September 8, 2019:
  • Waiver of prior authorization requirements for critical Medicaid services
  • Waiver of service limitations to ensure a recipient requiring critical Medicaid services during the storm receives such care
  • Temporary postponement of the Preadmission Screening and Resident Review processes
  • Waiver of the Medical Certification for Medicaid Long-term Care Services and Patient Transfer Form (Form 5000-3008) prior to admission to a nursing facility
Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1-877-254-1055.

 
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Governor has issued executive order 19-190, an ammendent of executive order 19-198 which declared a state of emergency regarding Hurricane Dorian for the following 26 counties: Baker, Bradford, Brevard, Broward, Clay, Duval, Flagler, Glades, Hendry, Highlands, Indian River, Lake, Martin, Miami-Dade, Monroe, Nassau, Okeechobee, Orange, Osceola, Palm Beach, Putnam, Seminole, St. Johns, St. Lucie, Volusia, and Union. 

Please take precaution you need to protect your family -- you will not be denied for medically necessary services.  DentaQuest of Florida will have a claims exception and expedited authorization. These processes apply to covered services provided during and outside of the grace period for services provided as a part of pre-storm evacuation and post- storm recovery. The claims exception and expedited process are applicable to participating and non-participating providers. In order for non-participating and participating providers to get reimbursed for services provided during this period the following steps are required: 

 

Participating Providers 

  • Services normally not requiring an authorization should be billed following the standard claims submission process, there is no additional information required to process these claims 
  • Services requiring prior-authorization will not be denied solely on the basis of not obtaining a prior authorization; in order for an authorization of payment to be provided, providers should submit their request to utilization management. 
  • In the request, please provide a point of contact in order to provide expedited authorization information 
  • Claims should be submitted through the regular claims submission process once the authorization number is provided; claims submitted without a billing number are subject to delayed processing 
  • Services must be covered benefits and appropriate billing and coding requirements continue to be applicable 
  • Our claims system requires a billing number and basic provider information in order to pay non- participating provider claims 

Non-Participating Providers 

  • Services that typically do not require a prior authorization for participating providers will only require notification and formal written request with essential clinical information. 
  • The formal credentialing process will be waived for non-participating providers; however, the provider must send the following information as part of the request: Contact information, Tax Identification Number, NPI Number, Service address, Medicaid number 
  • If you have questions regarding what services require prior authorization, please contact our Provider Relations Department through the number provided above 
  • For non-participating providers who are not registered with the state of Florida or out-of-state providers who have provided services to our displaced members during the grace period, should be registered with Medicaid. The Agency has provided instructions on the expedited process for providers to enroll through their portal: http://portal.flmmis.com/FLPublic/Provider_AgencyInitiatives/Provider_UrgentInfo/tabId/146/De 
  • Providers may also contact our provider relations department for guidance and direction on how to begin the registration process 

Emergency Contact Information:
  • Florida AHCA Member Services: Statewide Medicaid Dental Health Program
    • (888)-468-5509
  • Florida Provider Services:  DentaQuest General Provider Services Queue:
    • (877) 468-5581
  • Florida Healthy Kids Member Services: DentaQuest General Member Services Queue:
    • (888) 696-9557