Community Care Plan (CCP), the health plan with a heart, is an entity owned and operated by South Florida’s most experienced names in healthcare: Broward Health/ North Broward Hospital District and Memorial Healthcare System /South Broward Hospital District in Broward County. CCP is a member of Florida Association of Health Plans (FAHP) and the Association of Community-Affiliated Plans (ACAP). CCP has been awarded an Accreditation status of Accredited by the
National Committee for Quality Assurance (NCQA). CCP is fully accredited by Accreditation Association for Ambulatory Health Care as a Health Plan (AAAHC).
Medicaid and Florida Healthy Kids:
CCP, through the Medicaid contract with the Agency for Health Care Administration (AHCA), provides services to Medicaid populations in Broward County. As the first Provider Service Network in Florida, CCP has managed Medicaid services since March 2000.
Effective January 1, 2020, CCP is a health plan option for Florida Healthy Kids, a KidCare program, in:
- Broward
- Indian River
- Martin
- Miami-Dade
- Monroe
- Okeechobee
- Palm Beach
- Saint Lucie
Commercial Plans:
CCP is contracted to provide Third-Party Administrator Services and Benefits to Memorial Healthcare System employees and Community Care Plan Employees.
Effective September 1, 2020, CCP serves as the third-party administrator (TPA) for the Health Care District of Palm Beach County's District Cares Program administering the program's contracting, credentialing, and Provider services. Community Care Plan currently provides claim and authorization services to our District Cares Providers, and integrating the credentialing, contracting, and Provider services for the program will streamline the process and offer enhanced customer service to Providers.
Effective March 1,2019, Broward Health partnered with CCP to administer the health benefits for Broward Health’s Physician Payment for Uncompensated Care (PPUC) program.
Provider Operations:
Together, we collaborate with providers, leveraging our individual expertise to uphold the high standards expected by our community.
Our Provider Operations Department partners closely with providers to ensure that CCP members receive high-quality health care and services. CCP offers comprehensive support to providers and their offices for various procedures required by CCP, including but not limited to:
- Provider Orientation: A comprehensive introduction to CCP’s processes, policies, and systems, designed to ensure providers have the necessary tools and resources to succeed from the start.
- Educational Overviews on Compliance Issues: Regular updates and training on compliance topics, including billing practices, documentation standards, and regulatory changes to mitigate risk.
- On-Site Support at the Provider’s Office: Personalized support, including hands-on assistance and staff training.
- Processing Practice Changes and Updates: Support with updating practice information, including changes in provider status, location updates, and panel management.
- Verifying Eligibility, Reviewing Claims Status, and Requesting Pre-authorizations: Assistance with verifying patient eligibility, navigating the claims process, and obtaining necessary pre-authorizations to ensure smooth service delivery.
- Addressing Questions on Procedures, Policies, Reimbursement, and Other Program Information: A dedicated team is available to answer any questions related to CCP’s policies and procedures, reimbursement structures, and program details.
- Provider Portal Assistance: Support with accessing and using Planlink, the CCP Provider Portal. Including setting up accounts, navigating the portal, and troubleshooting issues. The portal allows providers to verify patient eligibility, submit and track claims, submit prior authorizations, and review important updates and resources.
Our Provider Operations Representatives conduct regular visits to CCP provider sites. During these visits, they assess the practice’s overall compliance with various regulatory and program standards, including:
- Access to Care: Ensuring members have timely access to health services, including urgent, preventive, and specialty care.
- Physical Accessibility of the Practice Environment: Evaluation of the facility’s accessibility, including accommodations for individuals with disabilities.
- Medical Record Keeping Practices: Assessment of the completeness, accuracy, and security of medical records in accordance with legal requirements.
- OSHA Compliance: Ensuring adherence to Occupational Safety and Health Administration (OSHA) standards for a safe and healthy workplace.
- Patient Confidentiality Procedures: Verification that patient information is handled in compliance with HIPAA and other privacy regulations.
- Facility Appearance and Adequacy: Ensuring the practice environment is clean, safe, and conducive to providing high-quality care.
Additional Resources and Support:
- Provider Portal Access: CCP offers an online provider portal where providers can check patient eligibility, submit claims, track claim status, and access important updates and resources.
- Provider Newsletters and Alerts: Regular communication through newsletters and alerts to keep providers informed of policy changes, new initiatives, and best practices.
- Provider Training and Webinars: Access to training sessions and webinars on topics such as coding updates, quality measures, and operational efficiencies.
- Network Engagement and Feedback: Opportunities for providers to engage with CCP through advisory boards, surveys, and direct feedback mechanisms to ensure their voices are heard and valued in our continuous improvement efforts.
CCP Provider Operations Representatives are available to assist with any of the services outlined above from 8:00 AM to 7:00 PM, Monday through Friday. For support, please contact the CCP Provider Operations Hotline at 1-855-819-9506.
