Providers for Community Care Plan MMA -
Claims Information

Providers shall submit claims in accordance with applicable state and federal laws. Unless otherwise stated in the Provider Agreement, the following guidelines apply:
 

  • Providers should submit all claims within 60 days of the date of service.
 
  • Claims submitted after a 180-day period from the date of service will automatically be denied by CCP for untimely filing.
 
  • Providers shall submit clean, complete, and accurate claims to CCP or its designated clearinghouse, via an 837 HIPAA compliant electronic media format. Provider agrees to work with CCP contracted clearinghouses. The advantages of electronic claims submission include, but are not limited to increased speed of payments, reduced data entry errors, less paper, and decreased clerical costs.
 
  • If you are currently submitting paper claims to CCP or using a clearing house that is unable or unwilling to submit claims electronically to CCP’s clearing house, you have options available to you that will allow you to save time and money send electronic claims today!


Electronic Claims Options

 

CCP and Availity partnered to offer free claim and Electronic Remittance Advice (ERA) options. We are excited to offer an enhanced free claim direct data entry option and ERA portal for your use. These are entirely sponsored by CCP, at no cost to you. These options enable providers to conduct business with CCP using the following methods:
 

  • Enter and submit claims, receive ERA, and exchange other electronic transactions using a browser-based application over the Internet.
 
  • Directly transmit HIPAA compliant ANSI transactions over a secure direct connection.
 
  • If you are currently registered with Availity, click here to access the Availity Portal for CCP.


Providers may also submit claims that require attachments via paper. All paper claim forms must be complete and accurate containing all data fields necessary for the claim to be considered clean.
 

Electronic Claims Registration

www.availity.com or 1-800-282-4548

Electronic Funds Transfer (EFT) Registration

EFT Request Form

Claim Submission Timeframe

180 days from date of service

Third Party Liability

It is the provider’s responsibility to notify CCP if an enrollee has coverage in addition to CCP-MMA.

Electronic Claims Filing

Availity Payor ID: 59065

Paper Claim with Attachment Submissions

Mail to CCP with complate information at the bellow address
Community Care Plan - MMA/ Provider Claim Appeals PO Box 841209
Pembroke Pines, FL 33084

Claim Inquiries

Check claim status electronically with our provider portal, PlanLink, or call
1-866-899-4828.  For information about PlanLink, click here.

Claim Appeals

Electronic Claim Appeals:
Participating providers with PlanLink provider portal access can submit claim appeals electronically. For more information, send an email to PlanLink@ccpcares.org
 

Paper Claim Appeals:
The Claim Reconsideration Form is available via this link MMA Request For Reconsideration Form

Mail to CCP with complete information at the below address:
Community Care Plan- MMA
Provider/ Claims Appeals
PO Box 841209
Pembroke Pines, FL 33084

Copayments

Copayments for CCP-MMA enrollees are waived.  See Provider Manual for details.

For detailed information, always refer to the Provider Manual.