Notification of Business Process Change for Checking Claims Status
Date: 04/15/24
Fort Lauderdale, Florida
Beginning June 17, 2024, please use the Secure Provider Portal to check the status of claims. Sunshine Health will no longer support general claims status over the phone. This change will allow our phone staff to focus on helping providers address more complex claims issues.
All Account Managers must ensure office staff and third-party billers have Secure Provider Portal access. Providers can also call Provider Services at 1-844-477-8313 and use the IVR claims self-service menu 24 hours a day, 7 days a week.
Self-Service Tools
Sunshine Health offers a full-service claim solution on the Secure Provider Portal. You can get claims status, amend claims, appeal claims and submit claim disputes and reconsiderations directly via the Secure Provider Portal.
Service | Web Portal | IVR |
Appeal Requests/Status (Rx) |
✓Fastest Results
| |
Appeals & Disputes |
✓Fastest Results
| |
Authorization Requests |
✓Fastest Results
| |
Authorization Requirements |
✓Fastest Results
|
✓
|
Authorization Status |
✓Fastest Results
|
✓
|
Benefits & Eligibility |
✓Fastest Results
|
✓
|
Claim Status |
✓Fastest Results
|
✓
|
Claim Submission (and Corrections) |
✓Fastest Results
| |
Co-payment Information |
✓Fastest Results
|
✓
|
Coverage Determination Requests/Status (Rx) |
✓Fastest Results
|
✓
|
Form Requests |
✓Fastest Results
|
✓
|
Provider Resources |
✓Fastest Results
|
Once a user has been verified, users should regularly log into the Secure Provider Portal. Account Manager(s) are the individuals assigned as the primary contact within a provider organization. To learn more about the Account Manager role, tasks and responsibilities, please view our Secure Provider Portal tips.
Questions?
- If you have any questions, please call Sunshine Health Provider Services at 1-844-477-8313 or visit the Secure Provider Portal.
- Our Provider Engagement staff are also here to help answer questions. Visit the Find Your Administrator tool to confirm the individual supporting your specialty and region.
- We encourage you stay up to date on Sunshine Health provider notices by reviewing and bookmarking Provider News.
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