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Manuals, Forms and Resources

Provider Manual

Medicaid (MMA), Comprehensive Long Term Care (LTC) and Child Welfare Specialty Plan (CWSP) Provider Manual (PDF)

Billing Manual

Medicaid Provider Billing Manual (PDF)

In Lieu of Services Resource Guide

The Medicaid In Lieu of Services Resource Guide (PDF) describes the ILOS benefits, eligibility requirements, limits and prescribing rules.

Claims Related Forms

General Provider Forms

HEDIS

BMI Graph Tool

BMI Chart Form (PDF)

PaperFree Florida

Training

Provider Manuals and Guides

Claims and Payments

Billing

Provider Payment forms

Medical Management

Prior Authorization Resource

Medicare Pre-Auth Disclaimer: All attempts are made to provide the most current information on the Pre-Auth Needed Tool. However, this does NOT guarantee payment. Payment of claims is dependent upon eligibility, covered benefits, provider contracts and correct coding and billing practices. For specific details, please refer to the Allwell from Sunshine provider manual. If you are uncertain that prior authorization is needed, please submit a request for an accurate response.

Authorization Forms

Authorization requests may be submitted by secure web portal and should include all necessary clinical information.

Quality of Care

BMI Graph Tool

BMI Chart Form (PDF)

For Ambetter information, please visit our Ambetter website.