A Division of the Agency for Health Care Administration
Florida Medicaid Health Care Alert January 18, 2018
Provider Type(s): All
Provider Enrollment Screening Enhancements Medicare Provider Records
The Affordable Care Act requires that the Agency for Health Care Administration (Agency) conduct pre-and post-enrollment screenings to ensure that providers initially meet and continue to meet the enrollment criteria for their provider type.
As an enhancement to the provider screening process, the Agency will soon implement automated checks to compare Florida Medicaid provider application data against Medicare's Provider Enrollment Chain of Ownership System (PECOS) database for those providers who are enrolled in both Medicare and Florida Medicaid.
All providers currently enrolled in Medicare are encouraged to review the information on their Medicare PECOS provider file, and to promptly complete any necessary updates, to ensure that Florida Medicaid receives current and accurate information. Items that will be checked include the provider name, tax ID, National Provider ID, ownership, date of birth, and the service address.
The Agency will implement the automated checks as part of the Florida Medicaid provider enrollment screening process in early 2018. Look for future alerts related to this and other enhancements.
Florida Medicaid Health Care Alert September 01, 2017
Provider Type(s): All
Notification of Changes to the National Provider Identifier (NPI) Registration Process
The Agency for Health Care Administration (Agency) is announcing that an update to the NPI registration process was implemented on August 25, 2017.
* “Date of Service” – The claim’s NPI must be on the provider’s record for the date of service, regardless of date of submission.
* “Date of Submission” – The claim’s NPI must be on the provider’s record for the date of submission, regardless of date of service.
Providers can view the “Date Used for Claims” field on their secure Web Portal page.
The Agency has posted three NPI-related documents on the Enrollment Forms page of the public Web Portal as part of this process change.
NOTE: The Agency will continue to accept the old NPI Registration Form through October 31, 2017. After October 31, 2017, only the revised NPI Registration Form (August 2017) will be accepted.
Providers may contact the Provider Enrollment Call Center at 1-800-289-7799, option 4, or their local Field Services Representative for any assistance with the enrollment process.