For Providers

If you need to check enrollee eligibility, assistance with a referral, submit an authorization, report a hospitalization, check status of an authorization or a claim, or want the claims submission address, see the directory of departments.

 

Attention Providers: Please take note of PHC Florida’s continuity of care requirements.

 

Attention Providers: PHC Florida is postponing the transition of behavioral health services to Magellan Health to May 1, 2019.  See the Provider Bulletin or more details.

 

If you are a contracted provider with PHC Florida, thank you for being part of a dynamic specialty health plan that cares for some of Florida’s most vulnerable population.

If you are considering joining PHC Florida, welcome.  PHC Florida is an HIV specialty Medicaid managed care plan serving HIV-positive Medicaid recipients who live in Broward, Miami-Dade and Monroe Counties.

PHC Florida offers unique provider and member benefits and services:

• HIV specialty network.  PHC Florida identifies specialists in the community who have the most experience in treating patients with HIV.
• An experienced care management panel comprised of HIV-expert physicians, nurses and pharmacists who actively practice HIV medicine
• Patient care coordination through Registered Nurse Case Managers who are assigned to each member to assist in coordination of treatment plans, complex care delivery, referrals to community-based resources, disease management education, and medication adherence
• Access to ACCME-accredited continuing education at reduced or no cost to providers
• Open invitation for provider participation in the plan’s quality improvement committees, e.g., pharmacy and therapeutics, standards and protocols, utilization management and credentialing committees
• HIV-related therapies that do not require prior authorization

PHC Florida stresses prevention and education, promotes positive lifestyle changes, improves medical self-management, and increases patient and family satisfaction.  The plan strives to improve the well being of patients by providing a medical home with providers who are experts in delivering care to people who are HIV-positive.

PHC Florida is an affiliate of AIDS Healthcare Foundation. The plan is backed by the world’s largest and most experienced HIV/AIDS health system operator.

PHC Florida is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC).  AAAHC is private, non-profit organization that develops standards to advance and promote patient safety, quality care, and value for health care through peer-based accreditation processes, education, and research. (By clicking on the above link, you will be taken to a website operated by AAAHC and not PHP.)

For more information about joining the PHC Florida provider network, please contact Provider Relations.

 

AHCA 062614 PHC MMA Form 17.0