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Online Member Account Ambetter from Sunshine Health

Details: Your Ambetter Online Member Account. Your Ambetter online member account is a powerful tool you can use anytime to manage your insurance plan. There, you can find information about your Ambetter coverage, access options for care and much more — all in one place. Your Ambetter online member account puts you in control of your health plan.

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Health Insurance Marketplace Benefits Ambetter from

Details: Health Management Programs. Find personalized help managing your chronic health condition so you have fewer complications. Through our health management programs, we offer telephone support, educational tools and behavioral health services, …

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Sunshine Health Member Services Ambetter from Sunshine

Details: Right Here. With Ambetter from Sunshine Health it's easy to take charge of your health. As an Ambetter member, you have access to the helpful tools and resources you need to manage your plan - all in one place, 24/7.

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Ambetter Select Plans

Details: Ambetter Select Plans. Our NEW Ambetter Select Plans offer a low and affordable monthly premium, with a selective network of healthcare providers and hospitals. The selective network ensures you have access to providers that have a history of better healthcare outcomes. Ambetter Select Plans are offered in Miami-Dade and Broward counties, and

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Ambetter Pay Your Premium

Details: Ambetter from Sunshine Health includes EPO products that are underwritten by Celtic Insurance Company, and HMO products that are underwritten by Sunshine State Health Plan. These companies are each Qualified Health Plan issuers in the Florida Health Insurance Marketplace.

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Ambetter from Sunshine Health Payor Fee Schedule Change

Details: Health Payor Fee Schedule Change. Date: 09/02/21. Thank you for your continued partnership with Ambetter from Sunshine Health. Our goal is always to deliver outstanding service to our members and providers. Ambetter’s payor fee schedule will be rebased on Oct. 1, 2021 from “Medicare Q4 2015” to “Medicare in effect on the date of service

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Reading An Ambetter Explanation Of Benefits (Eob) 2

Details: 45 Health Plan Payment –Sum of #39 for the claim Explanation Codes Descriptions 46 Payment, Denial, & Adjustment Explanation Codes for this Explanation of Benefits –This section lists all Explanation Codes from #38, their corresponding CARC and RARC codes (if applicable), and descriptions of all codes # Description

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2022 Prescription Drug List

Details: rnoM I sunshine health_ In.sum by Ct'ltic lnsr.trruN:e company Ambetter.SunshineHealth.com 2022 Prescription Drug List Effective January 1, 2022

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Ambetter Covered Drug Changes Effective January 1, 2022

Details: Ambetter from Sunshine Health wants to make sure that our members receive the best care at the lowest premium. One way that we do that is by monitoring the cost-effectiveness of drugs that are covered by our plan. To provide our members with the lowest possible premium for 2022, we’ve made changes to our list of covered drugs. These changes

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Health Insurance Provider Support Ambetter from Sunshine

Details: Ambetter from Sunshine Health offers a provider toolkit with materials to simplify administrative responsibilities. Learn more about our health insurance provider support.

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Ambetter Get Ready

Details: Ambetter Get Ready. Sign up for America’s #1. Marketplace health insurance. You demanded better Marketplace health insurance options, now we’re ready to deliver the care you deserve. Starting November 1, you have access to Ambetter from Sunshine Health. Submitting Form.

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Health Savings Account Benefits Ambetter from Sunshine

Details: A Health Savings Account (HSA) offers an easy way to save and pay for approved healthcare costs. It’s a savings account that you contribute to during the year, like a retirement account. Then, you can use it to pay for many health-related costs, such as …

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Ambetter Core Plans

Details: All the health plans offered on the Health Insurance Marketplace include certain items or services, or Essential Health Benefits (EHBs). When you choose Ambetter, you're covered on these essential medical care and wellness services:

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Health Insurance Premium Tax Credit Ambetter from

Details: A subsidy is financial assistance provided by the federal government that helps lower what you pay for health insurance each month (your premium). The size of your family, where you live, and your income are the three things that determine your subsidy. See if you qualify: Enroll.Ambetterhealth.com.

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Your Better Health Center

Details: Putting in those long hours can also have a negative effect on your mental health. Spending more time at work and worrying about work increase your stress levels. It also puts you at a higher risk of depression, anxiety, and other mental health issues. Working overtime also puts stress on personal relationships, which increases your risk of

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Know Your Mental Health And Substance Use Disorder Benefits

Details: Defining Mental Health/Substance Use Disorder benefits (MH/SUD) 42 U.S.C. 300gg-26. 42 U.S.C. 18031 (j) 45 CFR 146.136 (a) 45 CFR 156.115 (a) (3) The policy or contract shall define mental health benefits or substance use disorder benefits to mean items or services for the treatment of a mental health condition or substance use disorder, as

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Health Management Programs in Florida Ambetter from

Details: This way, you can control your condition better, understand it more and have fewer complications. We also provide behavioral health services, including depression management programs. Ambetter offers the following Health Management Programs: Call us at 1-877-687-1169 ( Relay Florida 1-800-955-8770 ).

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24-Hour Nurse Hotline in Florida

Details: For more details on COVID-19, Ambetter plan coverage, Telehealth, and prescription refills, please visit our FAQs page. We make it possible for you to talk to a registered nurse at any time—24 hours a day, 7 days a week, 365 days a year. Call us at 1-877-687-1169 ( Relay Florida 1-800-955-8770 ). Our nurse advice line helps you and your

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Health Insurance Special Enrollment Ambetter from

Details: If you’ve experienced a Qualifying Life Event, or a change in your insurance status, you may qualify for insurance during a Special Enrollment period. This means you can enroll or change your health insurance plan outside the regular open enrollment period. Most special enrollment periods last 60 days from the date of the qualifying life

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Provider and Billing Manual

Details: The Health Insurance Marketplace makes buying health insurance easier. The Affordable Care Act is the law that has changed healthcare. The goals of the ACA are: • To help more Americans get health insurance and stay healthy • To offer consumers a choice of coverage leading to increased health care engagement and empowerment January 12, 2021 7

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Payment Policy: Durable Medical

Details: Sunshine Health provides coverage for medically-necessary Durable Medical Equipment (DME) and medical supplies pursuant to the Statewide Medicaid Managed Care (SMMC) program. Medical equipment is used to manage and treat a condition, illness, …

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Do I Need a Registered Dietitian or

Details: A registered dietitian has four years of training to understand diseases like diabetes, high cholesterol, celiac disease, and food allergies to help you make healthy nutrition choices that can stave off and minimize the effects of disease. Registered dietitians usually work in formal settings like hospitals, clinics, and doctor's offices.

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Inpatient Authorization Form

Details: Behavioral Health . 779 C-Section Delivery . 121 Long Term Acute Care . 528 BH Chemical Substance Abuse . 720 Vaginal Delivery . 970 Medical . 529 BH Psychiatric Admission . 414 Premature/False Labor . 531 BH Eating Disorders . Inpatient Rehab . 402 Skilled Nursing Facility . 532 BH Crisis Stabilization Unit . 427 Rehab . 411 Surgical

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Florida Health Insurance Coverage Map Ambetter from

Details: My Health Pays Rewards® Coverage Area Map; Ways to Save; What is Ambetter? Shop and Compare Plans; Find a Doctor; Shop and Compare Plans. Use your ZIP Code to find your personal plan. See coverage in your area; Find doctors and hospitals; View pharmacy program benefits; View essential health benefits; Find and enroll in a plan that's right for

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Provider Toolkit Prior Authorization Guide

Details: provider.sunshinehealth.com. This is the preferred and fastest method. PHONE. 1-877-687-1169. After normal business hours and on holidays, calls are directed to the plan’s 24-hour nurse advice line. Notification of authorization will be returned by …

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Referral and Authorization Information Ambetter from

Details: The following are services that may require a referral from your PCP: Specialist services, including standing or ongoing referrals to a specific provider. Diagnostic tests (X-ray and lab) High tech imaging (CT scans, MRIs, PET scans, etc.)*. Planned inpatient admission*. Clinic services. Renal dialysis (kidney disease)*.

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Health Insurance Resources for Providers Ambetter from

Details: With Ambetter, you can rely on the services and support that you need to deliver the best quality of patient care. You’re dedicated to your patients, so we’re dedicated to you. When you partner with us, you benefit from years of valuable healthcare industry experience and knowledge. We’re dedicated to helping your practice run as

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