Skip to Main Content
Stay Connected on the Go! Download our Health Insurance Portal mobile app to search for care, view benefits and access your Member ID card. LEARN MORE AND DOWNLOAD THE APP
Stay Connected on the Go! Download our Health Insurance Portal mobile app to search for care, view benefits and access your Member ID card. LEARN MORE AND DOWNLOAD THE APP

Contact Us

Key Contacts and Important Phone Numbers

Sunshine Health provides a 24-hour help line to respond to requests for prior authorization. In addition, Sunshine Health staff is available from 8 a.m. to 8 p.m. Monday through Friday to answer provider questions and respond to provider complaints, emergencies and notifications.

After regular business hours the provider services line is answered by an automated system with the capability to provide callers with information about operating hours and instructions about how to verify enrollment for a member with an emergency or urgent medical condition. The requirement that Sunshine Health provides information to providers about how to verify enrollment shall not be construed to mean that the provider must obtain verification before providing emergency services and care.

The following are key services for which you may have a question and the phone number for that service:

  • To contact a Provider Services representative, call 1-844-477-8313.
  • For questions on medical or behavioral health authorizations, call 1-844-477-8313.
  • For pharmacy providers with questions on prescription claim processing call the Pharmacy Help Desk
    • Medicaid, Sunshine Health Mindful Pathways Specialty Plan (SMI) and Sunshine Health Pathway to Shine Specialty Plan (CW): 1-833-750-4392
    • Children's Medical Services Health Plan: 1-833-750-4401
    • Ambetter: 1-833-750-1160
  • For questions on the formulary or a drug that is provided through a retail pharmacy or specialty pharmacy call
  • For questions on advanced imaging, call 1-866-214-2569
  • For questions on arranging covered transportation for our members, call:

Sunshine Health Provider Call Center Policy on AI/Automated Calls

Sunshine Health would like to inform providers that our call center cannot accept calls from Artificial Intelligence (AI) systems or other automated platforms for tasks such as verifying claim status, obtaining remittance details, or addressing any other types of inquiries. To protect member privacy and maintain HIPAA compliance, Sunshine Health representatives will only interact with live callers.

Providers are encouraged to use the Sunshine Health Secure Provider Portal or Availity Essentials for quick access to essential information. If you have specific questions or need assistance, please reach out to your Sunshine Health Provider Engagement Account Manager. To find your assigned PEAM, use the Find Your Account Manager tool.