Provider Resources

Click on the applicable form, complete online, print, and then mail or fax it to us.

Humana, Sunshine, Simply, Coventry f.k.a Aetna Better Health (HK/Medicaid), MMM of Florida and Devoted Health

Patient Intake Form
Patient Upgrade Form (103 Kb)
Patient Splint Form (44 Kb)

Aetna & Coventry (Commercial & Medicare)

Authorization Form
Upgrade Request Form
Splint Request Form

Training
Materials

Training Attestation
Enhanced UM Model 3.0 (2018)
Aetna Better Health (Coventry) Medicaid and Healthy Kids
Devoted Provider Manual
Humana Provider Manual
MMM-FL Provider Manual
Simply Provider Manual
Sunshine Provider Manual
Human Trafficking

FWA

All ATA-FL providers are required to report concerns about actual, potential or perceived misconduct to the ATA-FL Corporate Compliance Department at:

1 (866) 321-5550

Forms

For your convenience, our most commonly used physician and provider forms are available.

Intake Form (Fillable PDF)
Upgrade Form (Fillable PDF)
Splint Form (Fillable PDF)

Portals

Our electronic tools make it easier and faster to check claim status, member eligibility, and more.

WonderBox Portal
WonderBox Requests
HS1 Web Portal
HS1 Web Portal Requests

ATA of Florida's newsletter allows us to broadcast general provider communications by email.