A Florida day can include a Medicaid plan, First Coast, and a PIP insurer. Those are three claims. The Agency for Health Care Administration runs Florida Medicaid. Most members are in a Statewide Medicaid Managed Care plan, and the plan is regional. The claim goes to that plan. It does not go to Georgia Medicaid because the member spends winters in both states.
A Florida day can include a Medicaid plan, First Coast, and a PIP insurer. Those are three claims.
The Agency for Health Care Administration runs Florida Medicaid. Most members are in a Statewide Medicaid Managed Care plan, and the plan is regional. The claim goes to that plan. It does not go to Georgia Medicaid because the member spends winters in both states.
Medicare Part A and Part B for a Florida practice go to First Coast Service Options, Jurisdiction N. Alabama and Georgia use Palmetto GBA, Jurisdiction J. A Florida Medicare claim sent to Palmetto is in the wrong jurisdiction.
Florida is a no-fault state. Personal injury protection is billed to the auto insurer, not to the health plan. A work injury is billed under the Division of Workers' Compensation to the employer's carrier in Florida. Neither one is a Medicaid plan claim.
Eligibility for a Florida visit has to name the product. A Medicare beneficiary, a Statewide Medicaid Managed Care member, and a PIP patient can sit on the same schedule. The payer ID changes with the product. Credentialing with one Medicaid plan does not cover the other plans in that region.
First Coast Service Options, Jurisdiction N. Georgia and Alabama use Palmetto GBA, Jurisdiction J.
To the personal-injury-protection insurer. It is not billed to the health plan or to Florida Medicaid.
The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.
