Coordinated Care for Optimum Health
A dedicated team of leading HIV/AIDS physicians, caregivers and experts are the heart of Clear Health Alliance. Together they work with members to develop a treatment plan and coordinate services that match their needs.
Clear Health Alliance Medical Policy
Managed Medical Assistance (MMA) Provider Materials
MMA Regional Provider Directories
Region 1: Escambia, Okaloosa, Santa Rosa, and Walton Counties Provider Directory
Region 2: Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington Counties Provider Directory
Region 3: Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, and Union Counties Provider Directory
Region 5: Pasco and Pinellas Counties Provider Directory
Region 6: Hardee, Highlands, Hillsborough, Manatee and Polk Counties Provider Directory
Region 7: Brevard, Orange, Osceola, and Seminole Counties Provider Directory
Region 8: Charlotte, Collier, DeSoto, Glades, Hendry, Lee and Sarasota Counties Provider Directory
Region 9: Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie Counties Provider Directory
Region 10: Broward County Provider Directory
Region 11: Miami-Dade and Monroe Counties Provider Directory
ICD-10 News from Clear Health: click here
Provider Portal: click here
Provider Services: (877) 915-0551
Beacon Health Options: www.beaconhealthoptions.com
Toll Free: 1-800-221-5487 Fax: 1-800-370-1116
MMA 2015 Cultural Competency Plan
Physician Cultural Competency Independent Training Module
For information about diabetes: www.diabetes.org
SIMPLY PARTNERS WITH EMDEON ON NEW
ELECTRONIC FUNDS TRANSFER AND VIRTUAL CREDIT CARD PROCESS!
Electronic submission (EDI)
Availity: Simply Healthcare Plans Payor ID # 00199
Emdeon: Simply Healthcare Plans Payor ID # 27094
For claims courier submissions, send claims to:
Clear Health Alliance
Smart Data Solutions
960 Blue Gentian Rd
Eagan, MN 55121
Clear Health Alliance
PO Box 21535
Eagan, MN 55121
Clear Health Alliance Quick Reference Guide: Click here for more detailed information.
Continuing Medical Educational Opportunities
Florida Caribbean AIDS Education and Training Center:
For information about Florida/Caribbean AIDS Education and Training Center (F/C AETC),
or to reqest training or a clinical consultation, please clinic on the link, www.fcaetc.org/events.
AAHIVM - American Academy of HIV Medicine:
For information about Florida/Caribbean AIDS Education and Training Center (F/C AETC) project ECHO model (Extension for Community Healthcare Outcomes),
or to reqest training or a clinical consultation, please clinic on the link, www.fcaetc.org/echo.
The American Academy of HIV Medicine is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV
disease. Its membership of HIV practitioners and credentialed HIV Specialists provider direct care to more than three-fourths of HIV patients in the US. For more information
about the American Academy of HIV Medicine, please clinic on the link, www.aahivm.org.
Fraud/Waste/Abuse Help Us Stop Fraud, Waste and Abuse
Clear Health Alliance wants you to get the respect you deserve and the service you expect. When fraud and abuse happens, it hurts you, your doctors and everybody in the health care system.
- Fraud - An intentional deception or misrepresentation made by a person or entity with the knowledge that the deception could result in some unauthorized benefit to him/herself, itself or some other person or entity. It includes any act that constitutes fraud under applicable federal or state law.
- Waste - An intentional or unintentional, thoughtless or careless expenditures, consumption, mismanagement, use, or squandering of resources; to the detriment or potential detriment of entities, but without intent to deceive or misrepresent.
- Abuse - Behaviors or practices of providers, physicians, or suppliers of services and equipment that, although normally not considered fraudulent, are inconsistent with accepted sound medical, business, or fiscal practices. The practices may, directly or indirectly, result in unnecessary costs to the program, improper payment, or payment for services that fail to meet professionally recognized standards of care, or which are medically unnecessary.
Things You Can Do to Stop Fraud, Waste and Abuse:
- When you receive a bill or Explanation of Benefits (EOB), look at it closely. Check to see if the services on your bill are the ones you actually received. Make sure the date of your visit is correct.
- Never give out or let anyone borrow your Clear Health Alliance Member ID number.
- Do not share your medical records with anyone except your primary care provider (PCP), hospital or health plan.
- Never ask your PCP for medical services or medicines you do not need..
- If someone offers you free tests or services using your Clear Health Alliance Member ID card, beware! If you think it sounds too good to be true, you are probably right. Call member services 1-877-577-9043 for more information.
Remember, committing fraud is against the law. One way to stop it is to report it. To report suspected fraud, waste or abuse, call our
Confidential Compliance and Fraud, Waste & Abuse Hotline at 1-877-253-9251 or you may email us, SIU@simplyhealthcareplans.com.
Please click here to filled out a confidential FWA referral form.
We Can! Ways to Enhance Children’s Activity & Nutrition
We Can! is a national movement designed to give parents, caregivers, and entire communities a way to help children 8 to 13 years old stay at a healthy weight. For more information,
Evidence Based Guidelines