Claims and Billing

At AmeriHealth Caritas Florida, we recognize that our providers want to receive payment in a timely manner. Please follow the guidelines below to help prevent any claim payment delays.

• Electronic claim payment options
• How to submit a claim
  Find out how to submit claims through Electronic Data Interchange (EDI) for faster, more efficient claims processing and payment.
• Change HealthCare ConnectCenter
• Claims submission via Change HealthCare
• Claim submission protocols
  Everything you need to know about how claims are processed and which claims are reimbursed.
• Billing guidelines for well-child visits 
  Special claims filing instruction for well-child visits.
• Level of care (LOC) billing guidelines
• In-office laboratory tests 
  Services listed are allowed to be performed in a physician's office.
• Explanation of Benefits (EOB) codes (PDF) 
• Interim billing guidelines
• Claim issues tip sheet (PDF)
  Tips for billing of taxonomy, PML, and matching logic provider data elements.

Refer to the provider manual (PDF) for a comprehensive guide to claims submissions and covered services.

Medical foster care (MFC) parents can use the Medical Foster Care Parent Quick Reference Guide (PDF) for contracting and claim submission information.

Have additional questions about the claims submission process? You can also call Provider Services at 1-800-617-5727 with any questions.