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Updated Notice for Florida Medicaid Providers Regarding Staywell’s Commitment to Service during Hurricane Irma

 
As previously communicated, Staywell Health Plan of Florida is committed to delivering quality care and service to our members and providers.  We waived authorization during the aftermath of Hurricane Irma to ensure access to care for you and your patients.  Today we are back to business as usual and hope you are as well.

If you feel any of your claims have been denied due to the circumstances directly related to the storm, we have implemented a Hurricane Irma Temporary Exception Process that allows you to seek an appeal.

Submit your appeal using the attached formThis PDF document will open in a new window. to our Appeals Department and we will review it expeditiously.  Please make sure to include supporting documentation.  By submitting an appeal through this process, you are attesting that you have been directly impacted by the storm in a manner that prevented following our normal health plan requirements – and submissions will be actively review for potential Fraud, Waste, Abuse and other false claims violations.  Each appeal submitted will be reviewed on a case-by-case basis, and submission of an appeal is not a guarantee of an overturn or payment. 
 
Please send medical appeals with supporting documentation to: 
Staywell Health Plan of Florida 
Attn: Appeals Department  - IRMA RELATED 
P.O. Box 31368 Tampa, FL 33631-3368 

For faster service, we strongly recommend using our fax process: 
Fax: 1-866-201-0657 Attn: Hurricane IRMA Appeal
Email: Appeals.Grievances@wellcare.com (with “Hurricane IRMA Appeal” in the subject line)

To be eligible to submit a claims appeal under our Hurricane Irma exception process, providers not already enrolled in Florida Medicaid (out-of-state or in-state) must complete a provisional (temporary) enrollment application.  The process for provisional provider enrollment is located at http://www.mymedicaid-florida.com.

The exceptions process only applies to claims submitted outside of the disaster grace period. For more information from the Agency for Health Care Administration (AHCA) visit http://ahca.myflorida.com/MCHQ/Emergency_Activities/Providers_Update.shtml. 

For providers within the State of Florida, along with out-of-state providers, who are not enrolled with Florida Medicaid and who provided services to Florida Medicaid recipients, Florida Medicaid created a provisional provider enrollment process, which includes waiving the requirements for providers to submit documentation, showing the nature of the treatment, along with other normally-required information, when applying for provisional enrollment. 

Florida Medicaid requires the following for provisional enrollment: 

A fully completed claim form containing the provider’s active National Provider Identifier (NPI), along with the provider’s SSN/FEIN; 
  • A signed Florida Medicaid Provider Agreement (MPA); 
  • A copy of the provider’s professional license 
This temporary enrollment process is designed to facilitate the claims payment process and encounter data submission for those providers caring for the needs of our Medicaid recipients who were impacted by the recent disaster. 

Please email the above information to FL_ProviderMedicaidRequest@wellcare.com with “Hurricane Irma Enrollment” in the subject line. 

Thank you for your help in ensuring the continuity of care and safety for our Florida Medicaid recipients during and after Hurricane Irma.

If you have any questions about our Hurricane Irma temporary exception process, we have a team of associates who can assist you.  Please call our Provider Customer Service at 1-866-334-7927.

Sincerely, 
Staywell Health Plan of Florida 


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Last Updated On: 10/3/2017