Healthcare providers looking for a streamlined, efficient way to manage patient information and administrative tasks will find the Ambetter from Sunshine Health Secure Provider Portal an essential tool. This digital platform offers comprehensive solutions to simplify medical practice operations and enhance patient care management.
Official Links
- Sunshine Health Provider Portal: https://provider.sunshinehealth.com
- Ambetter Provider Toolkit: https://www.ambetterhealth.com/en/fl/provider-resources/provider-toolkit/provider-toolkit-secure-provider-portal/
What Providers Can Do
The Secure Provider Portal provides a robust set of features designed to optimize healthcare provider workflows:
Key Functionality
- Verify member eligibility
- Manage claims
- Manage authorizations
- View patient lists
- Access patient demographics and history
- Submit batch claims
- Process prior authorization requests
Accessing the Portal
Getting Started
- Visit provider.sunshinehealth.com
- Click “Create an Account”
- Have your tax ID number ready during sign-up
Unique Portal Features
Multiple Practice Management
- Visibility across multiple Tax Identification Numbers (TINs)
- Single point of entry for accessing member information
Patient Management
- Daily patient list view
- Comprehensive screening for:
- Member eligibility
- Care gaps
- Patient history
Claims and Billing
- Free batch claims submission
- Detailed Electronic Funds Transfer (EFT) payment history
- Secure messaging capabilities
Prior Authorization Process
The portal includes innovative “Smart Sheets” that:
- Prompt for required clinical information
- Streamline authorization request submissions
- Reduce administrative burden
Privacy and Security
While specific security details aren’t fully elaborated in the source documents, the portal emphasizes secure access and protected information management.
Customer Support
Contact Information
- Provider Services Call Center: 1-844-477-8313
- Hours: Monday-Friday, 8 a.m. to 8 p.m. Eastern
- Ambetter Health Provider Support: 1-877-687-1169
Additional Resources
Provider Training
- Provider Town Hall sessions
- Ongoing integration updates
- Specialty-specific training opportunities
Supported Languages
The portal and support services offer assistance in multiple languages, including:
- English
- Spanish
- Kreyòl
- Vietnamese
- Portuguese
- And several others
Unprovided Information
Some details not explicitly covered in the source documents include:
- Specific security protocol details
- Comprehensive mobile app functionality
- Exact login process screenshots
The Ambetter from Sunshine Health Secure Provider Portal represents a comprehensive digital solution for healthcare providers, offering efficiency, accessibility, and streamlined administrative processes.
Disclaimer: Information based on July 2024 available documentation from Sunshine Health and Ambetter Health resources.
FAQ
Is Ambetter Sunshine State Medicaid?About Sunshine Health
Sunshine Health offers government-sponsored managed care through Medicaid, Long Term Care, Ambetter (Marketplace) and Allwell (Medicare). Additionally, we offer a specialty Medicaid health plan for children in or adopted from Florida’s Child Welfare system and a full pay Healthy Kids plan.
How do I check my Ambetter coverage?Your Ambetter online member account is a powerful tool you can use anytime to manage your insurance plan. There, you can find information about your Ambetter Health coverage, access options for care and much more — all in one place.
Is Ambetter a real health insurance company?In California, for example, Ambetter sells plans with a company called Health Net. And in New Jersey, Ambetter partners with WellCare. You can buy Ambetter plans on HealthCare.gov or your state health insurance marketplace, if your state uses its own website.
https://www.sunshinehealth.com/providers.html
Sunshine Health offers free online accounts for providers. Create yours and access the secure tools you need today.
https://www.ambetterhealth.com/en/fl/provider-resources/provider-toolkit/provider-toolkit-secure-provider-portal/
Get Started Now! Visit provider.sunshinehealth.comExternal Link and click Create an Account. Have your tax ID number ready during sign up.