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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!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
| Claims Information | |
|---|---|
| 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 a member has coverage in addition to the CCP Florida Healthy Kids coverage. |
| Electronic Claims Filing | Availity Payor ID: FHKC1 (the last digit of the payor ID is the number “one”) |
| Paper Claim with Attachment Submissions | CCP Claims Department- FHK |
| Claim Inquiries | Check claim status electronically with our provider portal, PlanLink, or call
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| Claim Appeals | Electronic Claim Appeals:
Faxed Claim Appeals:
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| Copayments | Copayments for CCP-MMA enrollees are waived. See Provider Manual for details. |
For detailed information, always refer to the Provider Manual.
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