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For services provided before the rollout of the new Statewide Medicaid Managed Care program, please visit the previous CHA provider portal.
For services provided after the new Medicaid plan rollout, please visit the Availity portal.
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Provider News
New Specialty Pharmacy Program
Effective 2/1/21, specialty medications for Simply/Clear Health Alliance Medicaid members will need to be filled at IngenioRx Specialty Pharmacy. IngenioRx Specialty Pharmacy will enable members on specialty medications and who have complex medical conditions to stay compliant with their specialty drug regimens.
Important notice: LogistiCare renamed ModivCare
As of January 4, 2021, LogistiCare Solutions, LLC, the nation’s largest provider of non-emergency medical transportation and our transportation provider for regions one through nine, has formally changed its company name to ModivCare Solutions, LLC.
Simply Healthcare Plans, Inc. Vision Services Vendor Transition to iCare Health Solutions, LLC
Effective December 31, 2020, EyeQuest (DentaQuest of Florida, Inc.) will no longer be providing medical and surgical vision services for Simply Healthcare Plans, Inc. (Simply) members. Beginning January 1, 2021, iCare Health Solutions, LLC will be the statewide subcontractor providing medical and surgical vision services to Simply members.
Important laboratory reminder
LabCorp is the exclusive independent laboratory provider for Simply and Clear Health Alliance.
New prior authorization requirements for outpatient procedures
Effective January 1, 2021, prior authorization (PA) requirements will be required for the CPT codes listed in this provider bulletin.
Updates to AIM Clinical Appropriateness Guidelines for Advanced Imaging
Updates to the AIM Clinical Appropriateness Guidelines for Advanced Imaging for claims with dates of service on and after March 14, 2021.
Prior authorization requirement for outpatient procedures if done in the outpatient hospital setting (place of service 22/billing code 013)
Effective January 1, 2021, prior authorization requirements will be required for the following CPT codes if requested in the outpatient (OP) hospital setting.
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.
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Featured Resources
Pharmacy information
Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Maternal Child Program
We offer a proactive case management program for expectant mothers and their newborns. The My Advocate® program provides pregnant women proactive outreach and education through interactive voice response (IVR), text or smartphone application.
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.