Current News

2020 Q3 Newsletter

10/27/2020

ATA of Florida's newest newsletter is out. In this edition you will find: * Demographic Changes or Provider Termination Requirements * Required Annual Provider Training * Affirmative Statement about UM Decision Making * Relaxing telehealth regulations does not mean relaxing fraud enforcement * Annual Quality Improvement Documents * Clinical Practice Guidelines * COVID-19 Relief Help * Fraud, Waste & Abuse

Demographic Changes or Provider Termination Requirements

10/26/2020

As needed, ATAFL, Health Plans, and Federal agencies perform ad hoc provider practice “mystery shopper” calls or site visits to measure variables including but not limited to provider roster accuracy; urgent, and routine appointment availability; currently accepting new enrollees, and any barriers to scheduling appointments experienced by enrollees.

Aetna Better Health Healthy Kids COPAY Waiver

10/14/2020

The purpose of this notice is to provide you with an update on Florida Healthy Kids (FHK) copay information for members that are enrolled with Aetna Better Health of Florida (ABHFL) plan. We would like to inform you that effective immediately, ABHFL will waive copayments for Speech, Physical and Occupational Therapy services rendered through December 31, 2020. Copayments will resume January 1, 2021.

New Provider Relations Representative

08/21/2020

Great news! Our Provider Relations Team is growing so that we may continue to provide you and your team with the support that you need. Your new Provider Relations Representative is Paula Powell and her contact details are located below; you are in great hands! Please feel free to contact Paula for all of your contracting and contract maintenance needs.

2020 Q2 Newsletter

06/30/2020

ATA of Florida's newest newsletter is out. In this edition you will find: * Free HIPPA Compliant Telehealth available to all ATA-FL providers * Telemedicine Guidance and Attestations * COVID-19 Relief Help * Relaxing telehealth regulations does not mean relaxing fraud enforcement * Fraud, Waste & Abuse * Annual Quality Improvement Documents * Clinical Practice Guidelines

Important Funding Announcement For All Medicaid Providers

06/19/2020

For all Medicaid and CHIP providers: The U.S. Department of Health and Human Services (HHS) has announced additional distributions from the Provider Relief Fund to eligible providers that participate in the Medicaid and Children’s Health Insurance Programs.

COVID-19 Protection Protocols

06/19/2020

As providers considered opening up their offices, ATA-FL has put together a COVID-19 protection protocol document to assist you and your staff to navigate the numerous safety measures that are recommended for medical offices

Medicaid Telemedicine Guidance & Attestation

01/05/2020

Effective immediately, American Therapy Administrators of Florida (ATAFL) shall reimburse Speech Therapy, Physical Therapy and Occupational Therapy services which apply to services through the Statewide Medicaid Managed Care program and the Florida Healthy Kids program.

Medicare Telemedicine Guidance & Attestation

01/05/2020

Effective March 6, 2020, American Therapy Administrators of Florida (ATAFL) shall reimburse Speech Therapy, Physical Therapy and Occupational Therapy services for services described herein which apply to services rendered to Medicare and Market Place (Commercial) enrollees.

Aetna Better Health of Florida Healthy Kids Expansion

01/05/2020

Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for ...

Simply Health Plan Healthy Kids Expansion

01/05/2020

Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for ...

2019 Q4 Newsletter

12/31/2019

Our latest newsletter is out. In this edition you will find: Important Claims and Billing updates, New Health Plan Implementation — CarePlus, New Health Plan Implementation — Community Care Plan, Profound level of impairment definition, Fraud, Waste and Abuse, Referring Provider NPI for Medicaid, Annual Quality Improvement Documents, Clinical Practice Guidelines and Demographic Changes or Provider Termination Requirements

New Health Plan Implementation — CarePlus

12/31/2019

Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for CarePlus’ Medicare enrolled members.

New Health Plan Implementation — Community Care Plan

12/31/2019

Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for CCP’s Medicaid and Healthy Kids enrolled members.

2019 Q3 Newsletter

09/30/2019

Our latest newsletter is out. In this edition you will find: Profound level of impairment definition, FMMIS checking NPI numbers on all claims, Fraud, Waste & Abuse, Annual Quality Improvement Documents, Clinical Practice Guidelines and Demographic Changes or Provider Termination Requirements

Provider Changes or Terminations Requirements

09/30/2019

Participating practices are required to notify ATA-FL immediately when: A Therapist employee has been terminated or is no longer treating patients at a specific location** or A location is closing or relocating

FMMIS to check NPI is present on all Claims

08/02/2019

Effective August 15, 2019, the Florida Medicaid Management Information System (FMMIS) will begin checking that the National Provider Identification (NPI) number for referring, ordering, and attending providers is present on fee-for-service claims and encounter submissions. This requirement is applicable for claims and encounters that include a date of service on or after August 15, 2019.

Molina - New Health Plan Implementation — Medicaid

07/02/2019

Effective July 1, 2019 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting (i.e. POS 11).

Molina - New Health Plan Implementation — Medicare & Commercial

07/02/2019

Effective July 1, 2019 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting (i.e. POS 11).

Encounter Data Submission Requirements

05/30/2019

Providers are required to submit claims encounters for all services rendered. Each and every visit and service are to be reported in the form of a claim to ATA-FL. This claim encounter ensures that the Plan’s members are receiving therapy services as authorized by ATA-FL per the POC.

Our Provider Web Portal and Its Security Features

05/01/2019

HS1 will assign the primary, or Account Owner, account. The Account Owner creates and assigns any other usernames for additional staff members. Employees should never share their credentials – each user should have their own username! Account credentials should not be shared amongst staff.

New Health Plan Implementation

03/06/2019

American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing outpatient setting (i.e. POS 11), for Aetna Better Health® of Florida Medicaid enrolled members of all ages.

Aetna Better Health of Florida Healthy Kids Expansion

03/06/2019

American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing outpatient setting (i.e. POS 11), for Aetna Better Health® of Florida Healthy Kids enrolled members in the expansion counties listed below.

Human Trafficking Training

02/21/2019

Attached please find our Human Trafficking Training PDF. This is an important issue for Florida, and creating awareness is key. We thank you in advance for helping us get this important information out there to you and your staff.

NON-PAR Provider Authorization Requests

01/31/2019

Non-Participating providers SHALL NOT EVALUATE, re-evaluate or treat beneficiaries managed by ATA-FL UNTIL THEY ARE CREDENTIALED by ATA-FL .....

Healthcare Alert - COC and Auth Requests

01/25/2019

As the Agency for Health Care Administration (the Agency) continues to transition Statewide Medicaid Managed Care (SMMC) enrollees as part of the SMMC Health and Dental Plan regional phased roll-out, providers are reminded of the SMMC Continuity of Care (COC) provision .....

Reminder to submit claims for all dates of services rendered

11/16/2018

HN1/ATA-FL is required to submit Encounters to each Health Plan for each claim that is received by a contracted provider. Why are Encounters so Important? Without a record of your claims encounter, it is as if the beneficiary never received the service from you .....

Critical Elements Required for Authorization Requests

09/17/2018

All treating providers must submit the following elements with each authorization request .....

2018 Q2 Newsletter

08/03/2018

ATA-FL's latest edition of our Provider Newsletter is out. In this issue you will find the following articles: * New Medicare Line of Business Health Plan;* New Medicaid LOB Health Plans; * Humana Medicaid termination date has been lifted; * Annual Quality Improvement Documents; * Our New Enhanced UM Model; * The Four Critical Elements * Schedule Your Training.

New Medicaid LOB Health Plans — Better Health, Clear Health Alliance, and Simply Healthcare Plans

06/29/2018

Effective July 1, 2018 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing facility or office setting (i.e. POS 11), for Better Health, Clear Health, or Simply Healthcare Medicaid enrolled members.

Simply Healthcare - New Medicare LOB Health Plan

06/29/2018

Effective July 1, 2018 American Therapy Administrators of Florida / Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or setting (i.e. POS 11), for Simply Healthcare Plan’s Medicare enrolled members.

UPDATE on our New Enhanced UM Model

04/12/2018

The Enhanced Utilization Management Model effective date has been changed to 6/1/2018. Our enhanced Utilization Management Model will reduce the administration burden for our provider network from multiple submissions of similar documentation to one submission per episode care.

Humana termination has been lifted

02/09/2018

Effective immediately, providers participating in the ATA-FL network in regions 6, 9, 10, and 11 may continue rendering services to Humana Medicaid beneficiaries. All authorization requests and claims payments will continue to be processed by ATA-FL ....

Provider Web Portal Updates

05/30/2017

We are pleased to announce the upcoming release of a new version of the Provider Web Portal (PWP). Available June 1, 2017, the new version will have a new look and new functionality that will allow you to be more effective, selfsufficient and paperless....

Q4 Newsletter

02/13/2017

Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ...

On 12/31/16 4-code set (97001-97004) will terminate

12/21/2016

Effective 12/31/2016 the 4-code set (97001-97004) for Physical Therapy (PT) and Occupational Therapy (OT) evaluative procedures will terminate ...

Address Updates: Wonderbox PWP URL & PO BOX for Paper Claims

11/9/2016

Effective November 7, 2016 the Provider Web Portal will have a new web address https://ata.therapyadmin.com/pwp. This will be the URL for you to use to access remittance statements, submit claims, view status of any claims and Patient Responsibility letters dated November 7, 2016 or later. ...

Wonderbox Provider Web Portal New Web Address

11/4/2016

This information is intended only for Coventry/Aetna Commercial & Coventry Medicare — The Wonderbox Provider Web Portal, which administers Coventry/Aetna Commercial & Coventry Medicare will have a new web address https://ata.therapyadmin.com/pwp. This will be the URL ...

Claim and Encounter Data Submission

08/15/2016

HN1/ATA-FL is required to submit Encounters to each Health Plans for each claim that is received by a contracted provider. Why are Encounters so Important?

Revised Documentation Requirements

08/10/2016

Important Changes That Will Impact Your Authorization Requests. UM Department will begin reviewing claim Encounter submissions prior to issuing a Step 2, Step 3, or an Upgrade and Documentation Requirements for Therapy Services - Plan of Care, Daily Visit Note & Therapy Service Discharge.

2016 Q2 Newsletter

06/29/2016

Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ....

Documentation Requirements

06/22/2016

Important Changes That Will Impact Your Authorization Requests. UM Department will begin reviewing claim Encounter submissions prior to issuing a Step 2, Step 3, or an Upgrade and Documentation Requirements for Therapy Services - Plan of Care, Daily Visit Note & Therapy Service Discharge.

Encounter Submissions

06/22/2016

2016 Q1 Newsletter

04/11/2016

Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ....

Winter Edition 2016 Newsletter

02/05/2016

Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ....

MMA Express Enrollment NOW Effective

02/03/2016

The State received approval of an amendment to Florida’s 1115 MMA Managed Medical Assistance waiver to allow for Express Enrollment beginning ....

Intake form and Pre-Service Determination Letters

01/07/2016

Effective Immediately the Intake Form must be completed in its entirety in order to be accepted for Authorization approval. Intake forms that are not entirely filled out will be returned back to ....

Migrating to 2 Separate Platforms

11/19/2015

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) .....

Cover Home & School

07/27/2015

Effective August 1st, 2015, for members enrolled in Sunshine Health Plan, American Therapy Administrators of Florida (ATA-FL/HN1) will cover therapy services in the home (POS 12) and school (POS 03) .....

New Intake Form

07/09/2015

Enclosed for your review and immediate use is the NEW ATA-FL Patient Intake Form. Please replace the current form that you are using with this NEW form effective immediately. The form is updated to provide .....

Sunshine Notice

03/31/2015

Effective April 1, 2015 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provide .....