WebbHealthcare Professional Referral Form. Complete this referral form for a Moffitt representative to contact your patient within 2 business days or call 1-888-663-3488 . The Patient Appointment Center is open Monday-Friday, 7am-6pm and Saturday 8-12 pm. WebbIn addition to small copays for certain services, you pay a monthly premium (payment) to Florida Healthy Kids to keep your child’s coverage. You can pay your premium in these ways: Go to the Florida KidCare website. Call 1-888-540-KIDS (5437) Mail to: Florida KidCare, P.O. Box 31105, Tampa, FL 33631-3105.
Simply Referral Form Pdf - Fill Out and Sign Printable PDF …
WebbIf a Prior Authorization is required, ask your doctor to submit the request to Simply … WebbManaged Medical Assistance: 844-406-2396 (TTY 711) Florida Healthy Kids: 844-405-4298 (TTY 711) Long-Term Care: 877-440-3738 (TTY 711) Already a member? Log in to your account and send us a message. Simply Healthcare Plans, Inc. is a Managed Care Plan with a Florida Medicaid Contract. For more information, contact the Managed Care Plan. plastic containers for hamsters
Florida Medicaid - Simply Healthcare plans Simply …
WebbStatewide Medicaid Managed Care Long-Term Care (SMMC LTC): • Phone: 877-440-3738 … WebbTo begin the form, use the Fill camp; Sign Online button or tick the preview image of the form. The advanced tools of the editor will lead you through the editable PDF template. Enter your official contact and identification details. Utilize a check mark to indicate the choice wherever required. WebbExecute your docs within a few minutes using our straightforward step-by-step guideline: Get the Arkansas Medicaid Pcp Referral Form you need. Open it up using the cloud-based editor and start altering. Fill in the blank fields; concerned parties names, places of residence and numbers etc. Customize the template with smart fillable areas. plastic containers for fluid