Required 5010 Changes for Claims Processed Prior to 01/01/2012
When adjusting, copying, or resubmitting claims via the Web Portal that were processed in 2011 or before, the Service Information fields must be updated with the below values:

Release of Service Information must be changed to “Signed STMT Permitting Release.”
Signature Source must be changed to “Generated by Provider.”

Note: For new claims submitted in the Web Portal on or after 01/01/2012, the Release of Service Information is auto-populated.

---

Florida Medicaid 5010 Implementation
Reminder: Florida Medicaid implemented the 5010 version of the HIPAA standard transactions on January 1, 2012.

If your X12 claims transactions are rejected after February 4, 2012, please validate that you are submitting the 5010 version to Florida Medicaid by consulting your clearinghouse or vendor. You may also click here for the Submissions Information page to learn about the 5010 versions for X12 files.

---

Expired and “Mismatched” Provider License Numbers
The Agency has completed an analysis regarding expired and mismatched license numbers for our Medicaid providers, compared to license numbers issued by the Department of Health or the Agency, through its Health Quality Assurance Division.

With the upcoming financial cycle (11/4/11) for providers with an expired or mismatched number, claims payments will be suspended. You can remedy this situation quickly by providing the Fiscal Agent a valid license, and suspended claims will then be released on the next weekend financial cycle. All affected providers will receive a letter describing this matching effort and steps to take to remedy the suspension of any claims. Click here for more information. If you are one of the providers affected by this matching process, and have any questions, please call HP at the number noted on your letter.

---

SLMB/QI1 Recoupment
On September 30, 2011, letters were sent to affected providers detailing the upcoming SLMB/QI1 Recoupment. Please click here for more information and instructions on how to access the claims associated with the recoupment amounts on the secure Web Portal.

---

Non-Reform Health Plans that Cover State Plan Dental
Please remember that non-Reform health plans may choose to cover State Plan dental services. We refer to this as "optional dental." If they choose to cover State Plan dental, then they receive extra capitation and are responsible for all State Plan dental services detailed in the Medicaid Provider Dental Services Coverage and Limitations Handbook.

The following health plans currently cover optional (State Plan) dental services in all of their non-Reform counties of operation:

• JMH
• Healthy Palm Beaches
• Integral
• Sunshine
• Molina

Please be careful to request service authorization and to bill accordingly.

---

Known Issues List
Please review the Known Issues and Informational Items List (Updated 1/31/2012) for details related to the MMIS.

---

Enrollment Fax Cover Sheet
You can now fax enrollment correspondence to Provider Enrollment by using the Provider Enrollment Fax Cover Page link located on the right-hand side of the Providers page in the secure Web Portal.

---

Eligibility Verification
REMINDER: When performing an eligibility verification on the secure Web Portal, the response may include references that state “limited to family planning benefit.” That statement is referring to the Family Planning Waiver benefit. As a reminder, in cases where a recipient has eligibility in multiple benefit plans, with one of the plans having a higher level of benefits (for example, Full Medicaid), the Full Medicaid plan takes precedence and more fully represents the recipient's eligibility.

Florida Medicaid's Web Portal solution provides communication, data exchange, and self-service tools to the provider community. The Web Portal consists of both public and secure areas (Web pages requiring a username and password). The public area contains general information, such as program awareness, notices, and forms.

You can now apply to be a Medicaid provider online using the provider enrollment wizard and track your application through the process. Once you are enrolled in Medicaid, you can access your personal information using your provider number and PIN (personal identification number).

You can:

• Update information on your provider number;
• Download a form to update address information;
• Perform eligibility verification;
• Request and track prior authorization and referrals;
• Submit and track claims;
• Access alerts and notices; and
• Receive Medicaid policy updates.

Providers can view contact information, training schedules, and training locations using the Area Office contact page. Providers can also receive training using computer based training courses.