New Medicaid Providers

1. Review the Provider Enrollment Policy, Chapter 2, for general enrollment requirements.
2. Determine which Enrollment Type will be used.
3. Determine which Provider Type and Specialty will be used. View the Provider Type and Specialty List to learn which qualifies for fully enrolled, limited enrolled, or order or referring enrollment.
4. Refer to the Interactive Enrollment Checklist to identify enrollment application requirements based on enrollment type, application type, provider type, and specialty, prior to starting the application process.
5. Review and save a copy of the Provider Enrollment Application Guide to use as a reference during the enrollment process.

Providers must enroll as one of the following:

Fully Enrolled allows providers to:

• Bill for services and receive payment directly from Medicaid.
• Participate in both the network of a Medicaid health plan as well as to bill for services and receive payment directly from Medicaid.

Limited Enrolled allows providers to:

• Participate in the network of a Medicaid health plan.

Ordering or Referring allows providers to:​​​​​​

• Participate solely as a physician, or other professional practitioner, as a referring, ordering, certifying, or prescribing provider of items or services for Medicaid recipients.

See below for additional information on provider enrollment:

• Provider Enrollment Application Guide
• Online Enrollment Wizard Frequently Asked Questions
• ROPA Provider Enrollment Overview Quick Reference Guide
• Streamlined Credentialing (Limited Enrollment) Presentation

By clicking "APPLY NOW" you will access the Online Enrollment Wizard and will begin to enroll as a new Medicaid provider. Before the application can be submitted, all supporting documentation must be uploaded. See the Supporting Documentation Resources section below for additional information on completing the application.

IMPORTANT:

• The name on the application must match the name on the license.
• Applicants must meet all requirements and qualifications as specified in the Coverage and Limitations Handbooks for the provider type they are requesting.
• Practices and facilities must be fully operational before enrollment with Florida Medicaid.
• Payment for services provided to Medicaid recipients prior to full approval are contingent upon approval into the program.

• The application process cannot be completed until all required documents as stipulated in the applicable Handbook sections, including an accurately completed Florida Medicaid provider agreement and background screening are received and matched with the online submission.
• Include the Application Tracking Number (ATN) provided by the Online Enrollment Wizard when uploading supporting documents.
• Before the application can be submitted, all supporting documentation must be uploaded.
• See Enrollment Forms to obtain the forms needed for initial enrollment.

IMPORTANT:

Fully enrolled group providers must ensure their individual group members are also enrolled and successfully linked to their Provider ID prior to submitting fee-for-service claims for payment.

Florida Medicaid requires that Behavior Analysis rendering providers have a unique email address and phone number. When completing the online application, applicants must enter the rendering provider’s email and phone number in the Service Location panel. Applicants should refrain from placing the group’s contact information in this panel.

The Agency for Health Care Administration (Agency) verifies the credentials of all providers applying to the Medicaid program.

Resources for Behavior Analysis (BA) Applicants

• BA Change of Ownership
• BA Common Application Deficiencies and Resolutions QRG
• BA Provider Enrollment Webinar
• BA Provider Enrollment FAQs

The Provider Enrollment Contact Center (PECC) is available to assist the provider with enrollment issues such as change of address, change of ownership, and re-enrollment issues.    Phone: 1-800-289-7799, Option 4