Setting Up Florida Medicaid

Special Instructions for Setting Up Florida Medicaid

To bill Florida Medicaid, there are a few extra steps that need to be taken in your Theralytics database. Please follow our recommendations below for more information.

1. Florida Medicaid will require the referring provider name and NPI in box 17. To set this up, first navigate to the client’s profile summary and click edit.

2. Under the Client Demographics tab, scroll down to the Rendering Providers for Therapy area.

3. Add the appropriate qualifier for box 17A (DN).

4. Please make sure that the referring provider’s name and NPI are filled out in the appropriate section and click save.

5. You can verify the referring provider information on claims that you have generated by using the print form 1500 option in the billing area.

6. The referring provider will appear in box 17 on the claim.

7. All remaining instructions regarding setting up the payer will be the same as for other insurances, please click here for more information.

Florida Medicaid EDI Instructions

Florida Medicaid requires certain steps before you can submit claims electronically to this payer. Please navigate to officeally.com and use the Resources tab to locate the form for Medicaid Florida for the most up to date information on enrolling to submit claims electronically.

1. Create a Web Portal Account

   1. Medicaid Florida will provide you with a letter with your PIN and Web Portal Setup.

   2. Once your web portal account has been set up, go to https://public.flmmis.com/public/pinletter and sign in with your information.

3. Go to Account Management and select Add Agent

4. Enter the following email address will.morrow@officeally.com

5. Set the username account as OACLAIMS and agree to the Terms of Service.

6. Click on Florida Web Portal at the bottom.

7. Set the following permissions for FLPortalProd:

   1. Claims

   2. Download 997

   3. Download TA1

   4. Reports

   5. Trade File

   6. Download 835

8. Click Save Changes

2. Link Clearinghouse using the EDI Agreement (Located under Providers > Demographic Maintenance > EDI Agreement)

3. Select Link to Billing agent/clearinghouse

4. Use the information below to complete the process

   1. 837 Health Care Claims Professional/Institutional

   2. Office Ally Trading Partner ID: 86259

   3. Billing Agent Provider Number: 992376400

   4. Billing Agent Name: Office Ally, Inc.

5. Contact Office Ally Customer Support (360-975-7000 Option 1) to confirm that you are approved to submit claims to Medicaid Florida.  You will need to provide Customer Support your Tax ID and Medicaid Florida Provider ID.

Florida Medicaid ERA Instructions

To receive your Electronic Remittance Advice from Medicaid Florida, please follow one of the two options below.

1. Enroll Online via the Portal (*note, you will need to be a fully enrolled provider with and active/pending EFT agreement on file with FL Medicaid) at  https://public.flmmis.com/

2. Complete the paper form and mail to HP Provider Enrollment.