Changes Effective 12/1/2015
Effective 12/01/2015, claims and referral administration for Sunshine Health Plan’s MMA and Child Welfare (CW) products and Coventry/Aetna Health Plan’s Commercial/Medicare and Medicaid/Healthy Kids (HK) products will be migrating to two separate platforms.
As of 12/01/2015 the Medicaid products for Sunshine Health Plan and the Medicaid and Healthy Kids products for Coventry Health Plan will be managed by Health System One. Health System One is currently managing the claims and referral administration processes for Humana and Amerigroup Health Plan products. This will not change. As of 12/01/2015 Medicare and Commercial products for Coventry/Aetna Health Plan will only be managed by WonderBox Technologies.
As a reminder ATA-FL manages therapy services for all regions for Sunshine Health Plan’s MMA and Child Welfare members and ATA-FL manages therapy services for Regions 1, 2, 3, 5, 6, 7 and Okeechobee and Indian River counties in Region 9 for Coventry Health Plan.
Payer ID 65064
Please note that effective 12/1/2015 Payer ID 65064, currently used for Sunshine Health and Coventry/Aetna EDI claims submissions, will be retired and all claims submitted to that Payer ID cannot be processed.
|Department||Sunshine MMA/CW & Coventry HK/Medicaid & Humana & Amerigroup||Coventry/Aetna Commercial & Coventry Medicare|
|Provider Relations||888-550-8800 Option 2|
|Provider Relations Fax||305-620-5973|
|Authorization||888-550-8800 Option 1||888-560-6855|
|Claims||877-372-1273 Option 6||888-560-6855 Option 2|
|Electronic Claims Submissions (EDI)||Direct Data Entry (DDE) through the HS1 Web Portal, or through the Clearinghouse, Emdeon, using:
Professional Payer ID: 65062
Institutional Payer ID: 12k89
|Direct Data Entry (DDE) through the WonderBox Provider Web Portal, or through the Clearinghouse, Smartdata Solutions, using:
Professional Payer ID: ATHAL
|Electronic Remittance Advice (ERA)||ERA provided via Emdeon. Provider must complete Emdeon ERA Provider Setup||You can obtain a hard copy of your EOB via the ATA Wonderbox Web Portal.|
|Paper Claims Submission||P.O. Box 350590
Fort Lauderdale, FL 33335-0590
|P.O. Box 511
Milwaukee, WI 53201
|Electronic Funds Transfer (EFT)||Initial payment sent via VPay with options for EFT or check available by calling: 855-388-8374 (Vpay EOB’s will be sent via Fax to Providers)||Use form EFT Authorization and fax it to 866-231-6344, or Email it to: Email it|
|Web Portal Access Requests||Administered by Health System One (HS1). Please complete the form at: www.ataflorida.com/pwp||Administered by WonderBox Technologies. To request access please send an email request to WonderBox.|
|Provider Web Portal Link||HS1 Web Portal||WonderBox|