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Nursing Home Enhanced Rates Effective October 1, 2021

Date: 11/22/21

Fort Lauderdale, Florida

Sunshine Health is aware of the Nursing Home Enhanced Rates that became effective October 1, 2021. Our Configuration Department is diligently working to load these rates as reported by the state for both PAR and Non Par providers.

Once the configuration is completed, Sunshine Health will review all payments made from October 1, 2021, to present and identify any underpaid claims. We will promptly reprocess all identified underpaid claims.

No additional steps are needed from providers. Here is information to better understand the process:

  • When claims are reprocessed, providers will receive an updated Explanation of Payment (EOP).
  • Providers will not be required to submit any claims data to receive additional payments on an underpaid claim.

For questions or concerns, please contact your Provider Relations representative. You can also call Sunshine Health Provider Services at 1-844-477-8313.