Florida Medicaid
Please follow the Enrollment Instructions listed below to become an electronic submitter for Florida Medicaid.
This connection is available for SolAce users ONLY.
SolAce Basic users Please Note: Our connection to FL Medicaid cannot be scripted due to the EDI system’s website structure therefore, once your EDI file has been generated, you will need to upload and download your files manually. We have a guide that will walk you through this process.
Required Documents for those applying for new Submitter ID's
The following documents are required enrollment documents that must be completed, signed and returned to the FL Medicaid office prior to initiation of electronic claims submission or inquiry.
1. Electronic Data Interchange Agreement
If the link above does not work properly, please download the form directly from the website:
Scroll to the bottom and click on the EDI Data Interchange Agreement link
If you have any questions regarding any of the documents in this package, please call the EDI Technology Support Center at 1-866-586-0961.
We can now process 276/277 requests (claim status). If this is a transaction you would like to utilize please make sure to enroll with the payer.
Electronic Data Interchange Agreement
Header
Enter your Medicaid Provider ID and NPI
Enter your Business/Practice or Provider Name
Complete your demographic and contact information
If you are a provider using ClaimShuttle to bill your claims directly to Medicaid, choose Provider
If you are a Billing Service, choose Billing Agent/Clearinghouse
Note to Billing Services: Once you receive your ID from Medicaid, you must have each of the providers you are billing for also complete a copy of this form and state they are a "Provider"
Section 1
Providers using SolAce basic to bill directly can enter their current Trading Partner ID if they have one or leave this section blank
Providers using a billing service must choose the second option and enter the billing services assigned Trading Partner ID on the line.
For transactions sets please choose either 837I or 837P and 835
837I = Institutional claims, 837P = Professional claims, 835 = EOB's
Section 2
Billing Services must complete this section. Provider's billing directly using ClaimShuttle/SolAce may skip this section.
Section 3
Please have the authorized official sign and date this application
Submitting your Forms
It is recommended that you keep a copy of all the forms you will be submitting for your records. Mail the enrollment forms reflecting original signatures to:
For Regular Mail:
Gainwell Technologies Provider Enrollment
PO Box 7070
Tallahassee, FL 32314-7070
For Overnight or Express Delivery:
Gainwell Technologies Provider Enrollment
2671 Executive Center Circle West
Suite 100
Tallahassee, FL 32301
Email: flediteam@dxc.com
It is very important that you complete and return the entire enrollment packet as described above. Incomplete packets will not be processed and will be returned to the submitter.
Waiting for a Response
Once the complete provider enrollment packet has been received, the documents will be processed. Processing will take approximately two weeks from the date of receipt. (Remember that mailing time can take as much as five days.)
After processing, a confirmation will be faxed to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, contact the Technology Support Center toll-free at 1-866-586-0961.
Testing
Once you have received your Submitter ID and Password from FL Medicaid, please call the ClaimShuttle Support Team and set an appointment for a Mailbox setup and Test Transmission to FL Medicaid.
Please have 25 test claims ready for testing. Test files should consist of a variety of claims that represent the type of claims you will be submitting once production status is achieved. Test claims will not be processed for payment but will be validated against production files; therefore, they must contain valid patient procedure, diagnosis, and provider information.