Providers for Florida Healthy Kids -
Services Requiring Prior Authorization

Below is the list of Florida Healthy Kids’ services that require prior authorization.

Please be advised that:

  • Prior Authorization is required for all Out-of-Network Services.
  • Prior Authorization is required for any service authorizations/pending cases prescribed or authorized before the member’s effective date with CCP.
  • Authorization requests should be submitted via the PlanLink provider portal and should include all necessary clinical documentation to facilitate the review and determine medical necessity. Incomplete requests will not be accepted. Providers who are registered to use PlanLink are asked to use the Web Portal when requesting prior authorization of medical services.
  • To request access to PlanLink, please visit our PlanLink Provider page.
  • Until PlanLink access is granted, providers may in the interim, fax the Community Care Plan - Florida Healthy Kids Prior Auth (PA) Request Form to CCP Utilization Management (UM) Department at 1-866-930-0969. All services rendered by out-of-network providers require prior authorization from CCP.
  • For PT, OT, ST services that require prior authorization, providers should contact Health Network One (HN1) at 1-888-550-8800.
  • For Home Health and DME services that require prior authorization, providers should contact Coastal Care Services, Inc. at 1-833-204-4535.
  • For any medication requests under the pharmacy benefit that require prior authorization, providers should fax the Community Care Plan – Florida Healthy Kids Pharmacy Prior Authorization Request form to Magellan Pharmacy services for review of medical necessity.

For Behavioral Health and Substance Use Services that require prior authorization, please refer to CCP’S BEHAVIORAL HEALTH AUTHORIZATION GUIDELINES.