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Florida medicaid exceptional claim form

Florida medicaid exceptional claim form 2025

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The document is a Request for Exceptional Claims Processing form, used by providers to request exceptions to the timely filing limit for claims. It includes sections for claims older than 12 months and those less than 12 months, outlining specific criteria under which exceptions can be granted. Providers must provide necessary documentation and submit a separate form for each claim.

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How do I report a change to Medicaid in Florida?

How to report a change in circumstances to Florida Medicaid. The Florida DCF Change in Circumstances Form can be found here, then mail or fax: Mailing Address: ACCESS Central Mail Center: P.O. Box 1770, Ocala, FL 34478-1770. Fax: 866-886-4342.

What number do I call for Florida Medicaid?

THE AHCA MEDICAID HELPLINE If you need help finding contact information for your plan, or if you are not enrolled in a plan, call our Medicaid Helpline at 1-877-254-1055 or visit .ahca.myflorida.com/Medicaid.

How do I verify Medicaid eligibility in Florida?

Methods to Verify Eligibility Providers may call Provider Services at 1-844-477-8313. Providers are asked to supply the members name and date of birth or the members Medicaid identification number and date of birth.

What is timely filing for Florida Medicaid?

To be considered filed timely, a claim must be submitted no later than one year after the date of service.

How do I appeal Medicaid in Florida?

Filing an Appeal Write us, or call us and follow up in writing, within 60 days of our decision about your services. 1-866-796-0530 (phone) or TTY at 1-800-955-8770. Ask for your services to continue within 10 days of receiving our letter, if needed. Some rules may apply.

Does Florida Medicare accept paper claims?

The Administrative Simplification Compliance Act (ASCA) requires that Medicare claims be sent electronically unless certain exceptions are met. Providers meeting an ASCA exception may send their claims to Medicare on a paper claim form.

What is the timely filing limit for appeals for Florida Medicaid?

You must file your appeal within 60 calendar days from the date on the Notice of Adverse Benefit Determination (letter) we send you. You may file your appeal by phone or in writing. If you file your appeal by phone, you must send us a written, signed notice (appeal letter) within 10 calendar days of your phone call.

How do I appeal a snap decision in Florida?

You should send your hand-written fair hearing request by fax to 1-850-487-0662 or by mail to Appeals Hearings Section, 2415 North Monroe Street, Suite 400, Tallahassee, FL 32303-4190. Although DCF says you can ask for a hearing by calling the Appeal Hearings Section at 1-850-488-1429, it is best to appeal in writing.

Florida medicaid exceptional claim form 2025

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