Notifications and Newsletters
In this ever changing world of health care, you as a provider need to stay on top of the latest news in our industry. Aetna Better Health of Florida helps you with this and takes the lead. We provide you with news and updates from us, as well as the latest breaking stories from the health care industry as a whole. From these pages you will see real time feeds from newsmakers like Centers for Medicare and Medicaid Services (CMS), Centers for Disease Control (CDC), and others. We know that you want to stay informed, and we’ll give you the tools to do so.
PROVIDER REMINDER
Providers Cannot Charge Florida Medicaid Recipients for Personal Protective Equipment
Florida Medicaid and Florida Healthy Kids providers cannot charge a recipient for Personal Protective Equipment (PPE) used during the delivery of a Medicaid covered service. Reimbursement from Florida Medicaid is payment in full for all services.
Additional information, including balanced billing prohibitions, is located in the Agency’s General Medicaid Policy.
https://ahca.myflorida.com/medicaid/review/General/59G-1.050_General_Medicaid_Policy.pdf
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Provider Notifications
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January 2021
2020
- December 2020 - Providers Monthly Webinar December Training Invitation (12/17/2020)
- November 2020 - Electronic Visit Verification (EVV) Requirements
- November 2020 - Co-Surgeon Modifier 62
- November 2020 - 835s and Remittance Advise Discrepancy Notice
- November 2020 - Providers Monthly Webinar November Training Invitation (11/19/2020)
- October 2020 - Provider Enrollment Revalidation Process Restart
- October 2020 - Florida Healthy Kids Copayment Extension
- October 2020 - DME/HME Services Rendered Form
- September 2020 - New Screening Tools and Resources
- September 2020 - Patient Responsibility Billing Guidelines
- September 2020 - Negative Balance - Collection Remittance NEW Process
- September 2020 - Long-Acting Reversible Contraceptive (LARC) Hospital Reimbursement
- September 2020 - COVID-19 Copayment and Authorization Extensions
- September 2020 - Adult Community Support Services
- September 2020 - Tellus eVV and Aetna Virtual Town Hall
- August 2020 - NEW Policies update effective date of service 07.28.2020
- August 2020 - Providers Special Trainings
- August 2020 - New HCPCS Codes for Depression Screening
- August 2020 - Upcoming Claims Review Information
- August 2020 - COVID-19 Copayment and Authorization Extensions
- August 2020 - Providers Monthly Webinar August Training Invitation 08/27/2020
- August 2020 - Obstetric (OB) Prior Authorization Requirements
- July 2020 - Prior Authorization Process for Custodial Care and Skilled Nursing Facility
- July 2020 - Florida Healthy Kids and Medikids Immunizations Update
- July 2020 - Polymerase Chain Reaction Testing Policy
- July 2020 - Home and Community Based Provider Retainer Payment Limitations
- July 2020 - Providers Monthly Webinar July's Training Invitation (07/30/2020)
- July 2020 - NEW Website Pharmacy Updates
- July 2020 - COVID-19 Waiver of Prior Authorization Requirements for Hospital Transfers
- July 2020 - COVID-19 Prior Authorization Reinstatement Process for Home Health & DME Services
- July 2020 - COVID-19 Prior Authorization Reinstatement Effective 06.19.2020
- June 2020 - Personal Protective Equipment Policy Reminder
- June 2020 - Providers Monthly Webinar Training Invitation (06/25/2020)
- June 2020 - Provider Relief Funding Information
- June 2020 - Inpatient Diagnosis Related Group (DRG) Adjustments
- May 2020 - Prior Authorization (PA) Changes for 2020
- May 2020 - COVID-19 Extended Benefits Information
- May 2020 - Providers Webinar Training Invitation (05/28/2020)
- May 2020 - COVID-19 Members Medicaid Eligibility Benefits
- May 2020 - TL Modifier Clarification for Early Intervention Therapy Services (EIS)
- May 2020 - COVID-19 Pandemic Impact Questionnaire
- April 2020 - Obstetric (OB) Ultrasounds Codes and Limits Requirements
- April 2020 - COVID-19 Electronic Visit Verification (EVV) Requirements
- April 2020 - Florida Healthy Kids COVID-19 Copayment Waiver
- March 2020 - Removal of Authorization Requirement for Observation Level of Care
- March 2020 - Providers Webinar Invitation - FHK & MMA Billing and Claims Training
- March 2020 - NEW Early Intervention Services (EIS) Prior Authorization and Modifier Requirement
- March 2020 - COVID-19 Telemedicine Guidance
- March 2020 - COVID-19 Prior Authorization Requirements
- March 2020 - COVID-19 Home Health Agency (HHA) Provider Survey
- March 2020 - Providers Webinar Invitation - Billing and Claims Training
- March 2020 - Member Rights and Responsibilities
- March 2020 - NEW Review Process for Sterilization Codes
- February 2020 - Allergy Testing Policy Reminder
- February 2020 - Grievance and Appeals Address Change Effective 03/01/2020
- February 2020 - Orthotics and Prosthetics Prior Authorization Requirements
- February 2020 - Billing Hospital Based Urgent Care Services
- February 2020 - Changes to Prior Authorization for Diabetic Supplies
- February 2020 - Home Health Services Coding and Billing Guidelines
- January 2020 - Medicaid Inpatient / Observation Notifications and Authorizations
- January 2020 - HCPCS Code J3145 Prior Authorization Changes
- January 2020 - Neuropsychological / Psychological Testing Prior Authorization Changes
- January 2020 - Prior Authorization for Custodial and Skilled SNF Provider
- January 2020 - Expanded Benefits Suppliers
- January 2020 - EVV Update Provider Notification
- January 2020 - Behavioral / Mental Health Vendor Clarification
- January 2020 - Value-Added Benefits for Florida Healthy Kids (FHK) Members
- January 2020 - Florida Healthy Kids (FHK) Primary Care Physician (PCP) Assignments Information
- January 2020 - Provider Manual
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Archived Notifications
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2019
- December 2019 - Florida Healthy Kids Provider Webinar
- December 2019 - Florida Healthy Kids Continuity of Care Provider Notification
- December 2019 - Electronic Visit Verification (EVV) Implementation Update
- December 2019 - Pediatric Oncology Clinical Review Process (Eviti)
- November 2019 - Florida Healthy Kids Townhall (Region 4)
- November 2019 - Housing Assistance Pilot Program (Region 7)
- October 2019 - Project ECHO
- October 2019 - Behavioral Health Provider Trainings
- October 2019 - New Prior Authorization Form
- October 2019 - Pharmacy Network Changes
- September 2019 - Integrated Care Management
- September 2019 - Florida Healthy Kids Contract Announcement
- August 2019 - Electronic Visit Verification (EVV) Solution Implementation
- August 2019 - Remit Advise and Provider Web Portal Education
- July 2019 - HEDIS Coding Well and Sick Visits
- July 2019 - Pharmacy Network Update
- June 2019 - Prior Authorizations - Custodial and SNF Education
- June 2019 - Aetna Better Health of Florida (ABHFL) Payer ID Information
- April 2019 - Unlisted & Non-Specific Code Education Provider Communication
- April 2019 - Evaluation and Management (EM) Information
- May 2019 - Abuse, Neglect, and Exploitation Provider Training (ANE)
- May 2019 - Medicaid Managed Care Long-Acting Reversible Contraceptive (LARC) Services Billing Information
- April 2019 - OB Updates
- April 2019 - Refund Checks Reminder
- March 2019 - Authorizations Fax Number Information
- February 2019 - Therapy Vendor Update
- January 2019 - Enhanced Ambulatory Patient Groupings (EAPG)
- January 2019 - NPI Medicaid ID Billing Requirements (C85)
- January 2019 - Provider Satisfaction Survey
2018
December 2018 - Continuity of Care (COC) Information
December 2018 - Participating Vendors List
November 2018 - EIS Therapy Approval Process
November 2018- Covered Flu Vaccines
October 2018 - Home Health and Personal Care Services Billing
October 2019 – MediKids Vaccine Information – Children’s Health Insurance Program (CHIP)
October 2018 - Hospice Guidelines
October 2018 - Non-Emergency Medical Transportation Changes
October 2018 - Hurricane Michael
September 2018 - Anesthesia Billing Modifiers
September 2018 - Integrated Care Management Programs
July 2018 - Recoupment Project Information
July 2018 - Urine Drug Testing (UDT)
July 2018 - No Prior Authorization Required on Select X-rays and Ultrasounds
May 2018 - MCNA Preventive Dental Benefits Outreach
May 2018 - E&M coding edits
May 2018 - Aetna Assitance Program Majority Stoneman Douglas HS
May 2018 - Enhanced Ambulatory Patient Groupings (EAPG) Physician Notification
May 2018 - ENS-Event Notification Service Participation
May 2018 - January CAP Payment Delay
May 2018 - National Drug Code NDC
May 2018 - Oncology Pre-Certification Process
May 2018 - Preferred Home Health Agency
May 2018 - REVISED-National Drug Code NDC
May 2018 - Risk Adjustment Letter
January 2018 - New Updates Bulletin v.2
January 2018 - Clinical Payment, Coding and Policy Changes
January 2018 - Prior Authorization Requirements
January 2018 - eviCore Fax Blast
January 2018 - MCNA Pregnant Woman Outreach Fax Blast
January 2018 - MCNA Preventive Dental Benefits Outreach
January 2018 - Medicaid and FHK Prior Authorization Requirements
2017
10/18/17 - Spinraza and Exondys 51 Drug Submission Update
10/10/17 - Covered Bowel Prep Products
10/10/17 - Covered Prenatal Vitamins List
8/15/17 - Change of Ownership for Skilled Nursing Facilities Information
8/11/17 - Prematurity Symposium Training Notification
8/10/17 - Event Notification Service (ENS) Participation
7/7/17 - Abuse Neglect Exploitation Provider Training
6/26/17 - FL Florida State Online Tracking System (SHOTS) Registration and Attestation
5/30/17 - Physical (PT), Occupational (OT) and Speech (ST) Therapy Benefits
3/30/17 - Medicare Cross Over Claims Information
3/29/17 - Vaccines for Children Program and Required Modifier
3/13/17 - Prior Authorization Providers Process
3/10/17 - Claims Editing and Adjudication Across Professional and Institutional Claim Types
3/10/17 - Hospitals Authorization Process
2/24/17 - CVS-Caremark Pharmacy Benefits Update
2/21/17 - Timely Filing Guidelines
2/21/17 - Cross Claim Implementation
2/21/17 - Powdered Medical Gloves Update
2/21/17 - Lab Services Vendor Information
1/18/17 - EviCore Healthcare Partnership Announcement
1/13/17 - Physical and Occupational Therapy CPT Codes Update
2016
10/11/16 - Home Health Preferred Provider
9/6/17 - Fraud Waste and Abuse Training
7/11/16 - Long Term Claims Information and Important Reminders
March 2016 - MMA Expanded Benefits for Pregnant Members
January 2016 - Long Term Care Claims Billing Information
January 2016 - Fax Florida Healthy Kids Pre-Cert Information
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Newsletters
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- Provider newsletter - Summer 2020
- Provider newsletter - Winter 2020
- Provider newsletter - Summer 2019
- Provider newsletter - Winter 2019
- Provider newsletter - Fall 2018
- Provider newsletter - Summer 2018
- Provider newsletter - Spring 2018
- Provider newsletter - Winter 2018
- Provider newsletter - Fall 2017
- Provider newsletter - Summer 2017
- Provider Newsletter - Spring 2017
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Policy Updates
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Pharmacy Updates