Florida SMMC Information Center
EVV and Claims Billing for Florida’s State Medicaid Managed Care Program
Starting on April 3rd, 2023 Florida Community Care Providers are required to use HHAeXchange to submit confirmed visits and bill directly through the free HHAeXchange Portal.
As of December 1, 2018, Humana and Sunshine Health, Children’s Medical Services, Molina Healthcare (the “MCOs”) require providers to use HHAeXchange to submit confirmed visits and bill directly to each MCO through the free HHAeXchange Portal.
The first step in effectively working with the MCOs is to fill out the Florida SMMC Provider Portal Configuration Questionnaire for your organization. The answers from your questionnaire will allow HHAeXchange to configure your agency’s portal. Please note that you only need to fill out the questionnaire once, regardless of how many MCOs you are contracted with.
EVV Mandate Updates
In accordance with the AHCA reporting requirement, please report any technical difficulties to HHAeXchange and our partner MCOs—Florida Community Care, Humana, Molina Healthcare, and Sunshine Health—by completing this form.
What are the key benefits of the HHAeXchange Portal to homecare agencies?
FREE Electronic Visit Verification (EVV) tools
Open Model EDI Integration with 3rd Party EVV Vendors
Real-time, two-way messaging with each MCO
Receive recipient demographics, authorizations, and plan of care electronically
Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle
Your Agency’s Billing Options
Option 1, Free HHAeXchange EVV: Our agency wants to use HHAeXchange’s free EVV system, provided by the MCOs. Great! If you’ve indicated that you’d like to use HHAeXchange’s free EVV system, the contact person listed on your questionnaire will receive more information in the coming weeks on how to set up your agency’s 800 numbers, upload caregivers into the HHAeXchange Portal, and begin processing EVV and claims.
Option 2, Use my Current EVV System: Our agency has an existing EVV system that we’d like to keep. It’s simple to connect your existing EVV system to the MCOs through the HHAeXchange Portal. Ensure that you’ve completed the questionnaire, and the HHAeXchange Integrations Team – FLintegration@hhaexchange.com – will coordinate with you to create an interface to process your existing EVV visits and claims.
What Services are a part of the Program?
PDN – LPN
PDN – RN