Important Provider Updates
Managed Medical Assistance Physician Incentive Program Update
Beginning October 1, 2016, Sunshine Health is paying qualified providers enhanced payments for certain qualified services as part of the Managed Medical Assistance Physician Incentive Program. For specific information about provider eligibility for enhanced payments, please refer to the MMA Plans Physician Incentive Program Chart (PDF) available on the Florida Agency for Health Care Administration’s website.
Sunshine Health Opioid Summit Toolkit
The Opioid Toolkit provides training on issues related to opioid abuse to all managed care and provider staff who address, prescribe or treat patients receiving opioids. This training helps providers manage the growth of opioid abuse and fraud. Relias Learning’s Opioid Package can help providers understand the opioid issue and best practices to avoid abuse. All content is delivered through an easy-to use user interface. Providers can access it online anytime, anywhere. Together, we can help our members – your patients – get and stay well.
If you are a contracted Sunshine Health provider, you can register now. If you are a non-contracted provider, you will be able to register after you submit your first claim.
Once you have created an account, you can use the Sunshine Health provider portal to:
- Verify member eligibility
- Manage claims
- Manage authorizations
- View patient list
Sunshine Health offers health insurance programs that fit the unique needs of our members.
View all of our available programs below. Select one to view more information and resources for our plan.
Health Insurance Marketplace
The Health Insurance Marketplace is an online shopping mall of healthcare plans. Sunshine Health's plan is called Ambetter. Ambetter offers affordable health care coverage for individuals and families. Depending on family size and income, a person may even qualify for help to pay their monthly premium.
Sunshine Health is a managed care organization (MCO) contracted with the Florida Healthy Kids Corporation to serve the Healthy Kids membership. Our number one priority is the promotion of healthy lifestyles through preventive healthcare. Sunshine Health works to accomplish this goal by partnering with the primary care providers (PCP) who oversee the healthcare of Sunshine Health’s Healthy Kids members.
REMINDER: The Sunshine Health "Stars Plus" plan will expire on December 31, 2016.
Long Term Care
Medicaid Managed Long Term Care for Medicaid enrollees 18 years and older who meet Nursing Facility level of care. Sunshine Health has developed the expertise to work with Medicaid and Long Term Care members to improve their health status and quality of life through the provision of quality services to meet the care needs of members.
Sunshine Health offers a statewide, specialized and comprehensive health plan for Florida’s children with an open child welfare case and those who have been adopted through the child welfare system. Together with our child welfare community-based care partners, we are improving the health and well-being of these children through coordinated care, services and support.