Community Care Plan (CCP), the health plan with a heart, is the first and longest standing provider service network (PSN) in Florida. We are owned by South Florida’s most experienced names in healthcare: Broward Health (North Broward Hospital District) and
Memorial Healthcare System (South Broward Hospital District) in Broward County.
CCP is a member of Florida Association of Health Plans (FAHP) and the Association of Community-Affiliated Plans (ACAP). The National Committee for Quality Assurance (NCQA) has awarded South Florida Community Care Plan Network (dba Community Care Plan) an accreditation status of Accredited for service and clinical quality that meets NCQA’s rigorous requirements for consumer protection and quality improvement. Community Care Plan has also earned Health Equity Accreditation for its Medicaid Health Plan from the National Committee for Quality Assurance (NCQA).
Community Care Plan is also accredited by the Accreditation Association for Ambulatory Healthcare as a Health Plan.
For Medicaid, CCP was awarded Managed Medical Assistance (MMA) Plus, including the serious mental illness populations for five regions (E, F, G, H, and I).
This includes the counties:
Florida Healthy Kids
CCP is currently a health plan choice for Florida Healthy Kids, a Florida KidCare program, in eight counties:
Employer health plans and uninsured
CCP serves as the Third-Party Administrator (TPA) for employer health plan and the uninsured. These include:
Our Provider Operations Department partners closely with providers to ensure that CCP members receive high-quality health care and services. CCP offers comprehensive support to providers and their offices for various procedures required by CCP, including but not limited to:
A comprehensive introduction to CCP’s processes, policies, and systems, designed to ensure providers have the necessary tools and resources to succeed from the start.
Regular updates and training on compliance topics, including billing practices, documentation standards, and regulatory changes to mitigate risk.
Personalized support, including hands-on assistance and staff training.
Support with updating practice information, including changes in provider status, location updates, and panel management.
Assistance with verifying patient eligibility, navigating the claims process, and obtaining necessary pre-authorizations to ensure smooth service delivery.
A dedicated team is available to answer any questions related to CCP’s policies and procedures, reimbursement structures, and program details.
Support with accessing and using Planlink, the CCP Provider Portal. This includes setting up accounts, navigating the portal, and troubleshooting issues. The portal allows providers to verify patient eligibility, submit and track claims, submit prior authorizations, and review important updates and resources.
Our Provider Operations Representatives conduct regular visits to CCP provider sites. During these visits, they assess the practice’s overall compliance with various regulatory and program standards, including:
Ensuring members have timely access to health services, including urgent, preventive, and specialty care.
Evaluation of the facility’s accessibility, including accommodations for individuals with disabilities.
Assessment of the completeness, accuracy, and security of medical records in accordance with legal requirements.
Ensuring adherence to Occupational Safety and Health Administration (OSHA) standards for a safe and healthy workplace.
Verification that patient information is handled in compliance with HIPAA and other privacy regulations.
Ensuring the practice environment is clean, safe, and conducive to providing high-quality care.
CCP Provider Operations Representatives are available to assist with any of the services outlined above from 8 AM to 7 PM, Monday through Friday. For support, please contact the CCP Provider Operations Hotline at 1-855-819-9506.
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