Payer List

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.

If you would rather submit your claims to the Availity Clearinghouse, who will then forward your claims to FL Medicaid, please click here for the enrollment instructions. Please make sure you call Availity for assistance completing the additional enrollment that's required in order to bill this Payer.

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.

If the link above does not work properly, please download the form directly from the website:

• http://portal.flmmis.com/FLPublic/Provider_EDI/Provider_EDI_RegistrationForms/tabId/64/Default.aspx
• Scroll to the bottom and click on the EDI 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.

Our Vendor Information

Electronic Data Interchange Agreement

• 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 SolAce 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"
  • Providers using SolAce 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.
    • 837I = Institutional claims, 837P = Professional claims, 835 = EOB's
    • Billing Services must complete this section. Provider's billing directly using SolAce may skip this section.
    • Please have the authorized official sign and date this section

    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

    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 SolAce Support Team and set an appointment for a Mailbox setup and Test Transmission.

    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.