Provider Services

For Providers

Provider Services

Community Care Plan (CCP) is a partnership fully owned and operated by South Florida’s most experienced names in healthcare: Broward Health/North Broward Hospital District (NBHD) and Memorial Healthcare System (MHS) in Broward.

CCP, through the Medicaid contract with the Agency for Health Care Administration (AHCA), provides services to Medicaid populations in Broward County. As the first PSN in Florida, CCP has managed Medicaid services since March 2000.

CCP has also partnered with the Department of Health/Children’s Medical Services (CMS) to form an Integrated Care System (ICS) to serve both the KidCare CMS T21 children as well as the MMA CMS T19 children. CCP currently manages the KidCare CMS T21 children with special health care needs in Miami-Dade, Monroe, Broward, Palm Beach, Martin, St. Lucie, Okeechobee, Indian River, Charlotte, Desoto, Manatee, Sarasota, Glades, Hendry, Lee, and Collier counties. CCP currently manages the CMS T19 Medicaid children in Broward County. As of August 1, 2014, CCP manages the MMA CMS T19 children with special health care needs in Miami-Dade, Broward, Monroe, Palm Beach, Martin, St. Lucie, Okeechobee , Indian River, Charlotte, Desoto, Manatee, Sarasota, Glades, Hendry, Lee, and Collier counties.

The CCP Provider Relations Department works closely with its providers to ensure that Medicaid families and CMS children receive quality health care and services. CCP is available to assist providers and their offices with the procedures required by CCP and CMS which would include (but are not limited to):

• New Provider Orientation;
• Assistance with Reporting Requirements;
• Educational Overviews on Compliance Issues;
• On-Site Support at the Provider’s office;
• Assistance with Practice Changes; Updates
• Verify eligibility, review claims and pre-authorizations in MED 3000
• Questions Regarding Procedures, Policies, Reimbursement, and Other Program Information.

Provider Relations Representatives conduct routine visits of CCP and CMS provider sites. During these visits, the Provider Relations Representative assesses the practice’s total compliance with various regulatory and program standards, including:

• Access to Care;
• Physical Accessibility to the Practice Environment;
• Medical Record Keeping Practices;
• Patient Confidentiality Procedures;
• Physical Appearance and Adequacy of the Facility;
• Appropriate Staffing (Medical and Administrative);
• OHSA Compliance;
• Grievance Procedures;
• Peer Review Procedures.

Provider Relations Department Representatives are available to assist you with any of the services outlined above from 8:00 am to 7:00 pm Monday through Friday.
Contact:

CCP Provider Relations Department
1-855-819-9506

CMSN-Medicaid (T19 MMA: South, Southeast, and Southwest Florida Regions)
1-800-988-5640 or 1-866-209-5022

CMS-KidCare (T21: South, Southeast, and Southwest Florida Regions)
1-866-202-1132
Other Important Phone Numbers
CMS Area Offices

• CMS Miami-Dade 1-866-831-9017
• CMS Marathon 1-800-342-1898
• CMS Ft. Lauderdale 1-800-204-2182
• CMS Ft. Pierce 1-800-226-1354
• CMS West Palm Beach 1-877-822-5203
• CMS Sarasota 1-800-235-9717
• CMS Ft. Myers 1-800-226-3290
• CMS Naples 1-239-552-7400