June 2020
Important Information for All Medicaid Providers – Act Now!

Federal COVID-19 relief funding is available for Medicaid and CHIP providers. Federal HHS has launched a Provider Relief Fund Payment Portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue. This will be used as a factor in determining their Provider Relief Fund payment. The payment to each provider is expected to be at least 2 percent of reported gross revenue from patient care. Restrictions apply, and providers should carefully read the posted materials.

Join their webcast to learn more about the application process. Please pre-register to reserve a spot on your preferred date:
Well Child Visits: COVID-19 Guideline From AHCA
We would like to share some new developments from the Agency For Healthcare Administration relative to well-child visits. The Agency is allowing limited use of telemedicine to accomplish well child visits where safe to do so. This is a great opportunity to reach out to our members and your patients and ensure ongoing well visits are up to date.

This information is from AHCA Alert sent out on 5/29/2020- Well-Child Visits Provided Via Telemedicine During the COVID-19 State of Emergency. You may sign up for Provider Alerts directly from AHCA and access Provider Alert archives at the following agency link:  http://portal.flmmis.com/FLPublic/Provider_ProviderServices/Provider_ProviderSupport/Provider_ProviderSupport_ProviderAlerts/tabId/48/Default.aspx

Telemedicine Well-Child Visits: Children Older than 24 Months through 20 Years
The Agency understands that well-child visits are just as important as sick visits to ensure children receive quality care at their medical home. Florida Medicaid reimburses for well-child visits in accordance with the recommended schedule developed by the American Academy of Pediatrics. To promote health and wellness through preventive care during the COVID-19 state of emergency, the Agency is expanding telemedicine to include well-child visits.

Providers may render a well-child visit using telemedicine (live/two-way communication that includes audio and video) during the state of emergency for children older than 24 months through 20 years for the following procedure codes:

  • 99382-99385
  • 99392-99395

Providers must append the GT modifier for live, two-way communication. The Agency and the Medicaid health plans will reimburse the same rate as if the service was delivered face-to-face.

Though it may be necessary to conduct a well-child via telemedicine, it is the Agency’s expectation that providers actively work to schedule a follow-up visit to administer immunizations and other physical components of the exam that could not be delivered using telemedicine. Immunizations are critical to reducing and eliminating preventable diseases. Immunizations should be scheduled as soon as possible to ensure children can remain on schedule for these important services. The follow-up visit will eligible for Medicaid reimbursement. Additional guidance will be forthcoming regarding the follow-up visit to render the remaining components of the well-child visit (i.e., a comprehensive physical exam and/or immunizations) .

Well-Child Visits: Children 24 Months and Younger
In accordance with the American Academy of Pediatrics guidance, providers should prioritize in-person newborn care, newborn well-visits, and immunization of infants and young children through 24 months of age. Therefore, Florida Medicaid will not reimburse for well-child visits performed via telemedicine for children ages 24 months and younger.

Please reach out to our Provider Relations email at providerrelations@lighthousehealthplan.com or your provider relations representative if you have any questions or would like to discuss ways we can partner to reach your patients and our members for well visits.

As always, thank you for all you are doing for our community and patients. Stay safe and healthy.

Lighthouse Health Plan
AHCA COVID-19 Alerts 

Please visit the AHCA COVID-19 Alerts web page to stay informed about AHCA’s response to COVID-19 as it provides specific information pertaining to facilities, Medicaid providers, and frequently asked questions regarding Florida Medicaid requirements during the state of emergency.

Welcome New Providers to our Network

All Ages Pediatrics
2910 Hospital Dr.
Bonifay, FL 32425

Bridgeway Health Clinics
137 Hospital Dr. NE
Fort Walton Beach, FL 32548

Children’s Orthopaedic Institute of Northwest Florida
710 Hospital Dr
Crestview, FL 32539

Pro Health One
1717 W Avery St
Pensacola, FL 32501

PruittHealth- Panama City
3212 Jenks Ave
Panama City, FL 32405

PruittHealth- Santa Rosa
5530 Northrop Rd
Milton, Fl 32570

Red Hills Surgical Center
1608 Surgeons Dr
Tallahassee, FL 32308

Southeast Association of Health Care Providers
5330 N Davis Hwy
Pensacola, FL 32503
Meet Kerrie Otano, Provider Relations Manager
Kerrie Otano has been with Lighthouse Health Plan since 2018, previously serving as Population Health Manager with the clinical team and now managing the Provider Relations team. Otano earned her nursing degree from Madison-Oneida BOCES in Rome, New York. Otano has 26 years of experience in nursing field and 17 years in clinical leadership and management, with the last 8 years working with health plans in a variety of roles. She is passionate about working with providers and practices to build lasting partnerships and excellent customer service.
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