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Medicaid Bulletin: Statewide Provider and Health Plan Claim Dispute Resolution Program

May 08, 2017 10:34 AM | Amanda Riordan (Administrator)

The following communication was emailed by Florida Medicaid on Monday, May 8.

Florida Medicaid Health Care Alert

May 8, 2017

Provider Type(s): All

Statewide Provider and Health Plan Claim Dispute Resolution Program


The 
Agency for Health Care Administration is contracted with MAXIMUS, an independent dispute resolution organization, to provide assistance to health care providers and health plans in resolving claim disputes. Claims submitted to managed care plans that have been denied in full or in part, or allegedly underpaid or overpaid may be eligible for dispute under the arbitration process.

To learn more about these available arbitration services, go to http://ahca.myflorida.com/medicaid/statewide mc/index.shtml or contact MAXIMUS directly at 1- 866-763-6395 (select 1 for English or 2 for Spanish), and then select Option 2.  Ask for Florida Provider Appeals Process.

Contact MAXIMUS for application forms and instructions on how to file a claim dispute.