Current News
2023 Q1 Newsletter
04/14/23
There’s a lot to discover in the Q1 issue of Networking. Our very own VP of Networking, Karen Chewning, has a network update. We’ll meet one of our own Network Providers, Sarah Sharpe, out of Florida and some network reminders.
2022 Q4 Newsletter
12/30/22
There’s a lot to discover in the Q4 issue of Networking, our very own VP of Networking, Karen Chewning, has a network update. We’ll meet one of our own Network Providers, Amy Baez out of Florida and how HN1 launched a free educational initiative by hosting a free 2 day test.
Avmed expansions effective 01/01/23
12/05/22
Effective JANUARY 1, 2022 Therapy Network of Florida (TNFL) will be the mandatory specialty network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility for AvMed’s expansion counties for Medicare enrolled members.
Devoted expansions effective 01/01/23
12/05/22
Effective JANUARY 1, 2022, Therapy Network of Florida (TNFL) will be the mandatory specialty network for outpatient physical therapy, speech therapy, and occupational therapy services provided in a free-standing facility or office setting (i.e., POS 11) for Devoted Health’s expansion counties for Medicare-enrolled members.
Simply expansions effective 01/01/23
12/05/22
Effective January 1st, 2023, Health Network One’s Therapy Network of Florida will be the mandatory network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting, for Simply Medicare enrollees in the expansion Counties below.
Florida Healthy Kids Copay Waiver
11/01/22
The purpose of this notice is to provide you with an update on Florida Healthy Kids (FHK) copay information for members that are enrolled with Aetna Better Health of Florida (ABHFL), Simply Health Plan (SHP) and Community Care Plan (CCP).
2022 Q3 Newsletter
07/30/22
In this edition our very own VP of Networking, Karen Chewning talks about compliance. We also get to meet one of our providers from Georgia, Jerison Speer who is treating people like people. Lastly you will learn what industry insiders are saying are the biggest trends, opportunities and challenges for rehab therapists.
Simply Healthcare Plans, Inc. and Best Care Assurance, LLC d/b/a Vivida Health’s (Vivida Health): Membership Acquisition
06/30/22
Effective November 1, 2022, Simply Healthcare Plans, Inc. (Simply) will serve the health care coverage needs of eligible Medicaid recipients in regions 8, including the recipients previously enrolled in Best Care Assurance, LLC d/b/a Vivida Health’s (Vivida Health). Therapy Network of Florida/Health Network One (TNFL/ HN1) will be the mandatory specialty network for Physical Therapy, Speech Therapy and Occupational Therapy services provided in a free-standing outpatient setting for these eligible Medicaid recipients of all ages.
2022 Q2 Newsletter
06/30/22
Social media is a great tool to connect with your community. In this issue, we’ll talk about best practices in social media we’ll meet one of our own Network Providers, Speech Therapist Elizabeth Peavy out of Georgia and our very own VP of Networking, Karen Chewning, has a few questions for you.
New Health Plan Implementation — AvMed Medicare
06/27/22
Effective July 1, 2021, Health Network One’s Therapy Network of Florida will be the mandatory network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting, for AvMed’s Medicare enrollees.
2022 Q1 Newsletter
03/17/22
In this edition: You’ll meet one of your own, network provider Dr. Michael Loeffler who’s been part of our Network for nearly three decades. We’ll also be giving you some insight into what’s happening with Medicaid as the Families First Coronavirus Response Act is set to lift sometime in 2022.
2021 Q4 Newsletter
12/30/2021
In this edition you will find: Effective 1/1/2022 Molina Medicaid Specialty Plan SMI Expansion into Regions 4, 5 and 7 * Clinical Practice Guidelines * Mystery Shopper Calls, Provider Changes and Terminations * Annual Quality Improvement Documents * Clinical Practice Guidelines * Required Annual Provider Trainings * Affirmative Statement about UM Decision Making * Fraud, Waste & Abuse
Billing Guideline Bulletin
12/02/2021
Beginning January 1, 2020, CMS requires the use of the CQ modifier to denote outpatient therapy services furnished in whole or in part by a physical therapist assistant (PTA) in physical therapist (PT) private practices, skilled nursing facilities, home health agencies, outpatient hospitals, rehabilitation agencies, and comprehensive outpatient rehabilitation facilities.
Medicaid Expansion: Molina Healthcare Specialty Plan
11/04/2021
Effective January 1, 2022, American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the specialty network for Physical Therapy, Speech Therapy and Occupational Therapy (PT/ST/OT) services rendered in a free-standing outpatient setting to Molina Healthcare of Florida Specialty Plan members.
Effective 10-1-21: Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers are Not Enrolled
08/06/2021
Effective October 1, 2021, any fee-for-service (FFS) claim submitted with a National Provider Identifier (NPI) for a provider not enrolled with Florida Medicaid will deny, and the provider will not receive reimbursement for services.
2021 Q2 Newsletter
06/29/2021
In this edition you will find: Required Annual Provider Trainings, Region 9 Medicaid Termination for Humana, ABHFL will no longer waive copayments, MyCharlie Extended till 11/30/21, Simply Healthcare Plans and Lighthouse Health Plan: Contract acquisition, Provider Code of Conduct, Mystery Shopper Calls, Provider Changes and Terminations Notifications, Fraud, Waste & Abuse, Enhanced Peer to Peer Process, Annual Quality Improvement Documents, Clinical Practice Guidelines
ATAFL has adopted an enhanced Peer to Peer process
04/09/2021
Effective February 22, 2021, ATAFL has adopted an enhanced Peer to Peer process. ATAFL can no longer accept verbal confirmation of the agreed upon level of impairment, if the documentation submitted does not support the requested level of impairment.
Simply Healthcare and Miami Children’s Health Plan: Contract acquisition
04/09/2021
Effective May 1, 2021, Simply Healthcare Plans, Inc. (Simply) will serve the health care coverage needs of eligible Medicaid recipients in regions 9 and 11, including the recipients previously enrolled in Miami Children’s Health Plan. American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing outpatient setting for these eligible Medicaid recipients of all ages.
2021 Q1 Newsletter
03/01/2021
In this edition you will find: * Therapy Assistants and Their Role in Evaluations & Reevaluations * Simply Healthcare Plans and Lighthouse Health Plan: Contract acquisition * Aetna Better Health - Florida Healthy Kids * Devoted Health Will Be Expanding Effective January 1, 2021 * Fraud, Waste & Abuse * Effective 10-1-21: Claims will Deny if Referring, Ordering, Prescribing, and Attending Providers are Not Enrolled * Annual Quality Improvement Documents * Required Annual Provider Training * RClinical Practice Guidelines
Clarification on Assistants Role in the Evaluation and Reevaluation Process
02/04/2021
The Occupational Therapist initiates and directs the screening, evaluation, and reevaluation process which includes analysis and interpretation of the data in accordance with federal and state laws, other regulatory and payer requirements, and AOTA standards of practice.
Updated Humana Region 9 Termination
01/19/2021
Effective May 1st, 2021, the agreement between Humana and ATA-FL in Region 9 shall be terminated.
Claims Will Be Denied If Not Enrolled
01/19/2021
Effective October 1, 2021, any fee-for-service (FFS) claim submitted with a National Provider Identifier (NPI) for a provider not enrolled with Florida Medicaid will deny, and the provider will not receive reimbursement for services.
Humnana Region 9 Termination
01/04/2021
Effective February 1st, 2021, the agreement between Humana and ATA-FL in Region 9 (Indian River, Martin, Okeechobee, Palm Beach and St. Lucie counties) shall be terminated.
2020 Q4 Newsletter
12/29/2020
ATA of Florida's newest newsletter is out. In this edition you will find: * Demographic Changes or Provider Termination Requirements * Relaxing telehealth regulations does not mean relaxing fraud enforcement * Get Paid Faster with vPay * Annual Quality * Improvement Documents * Clinical Practice Guidelines * Fraud, Waste & Abuse * COVID-19 Relief Help * Required Annual Provider Training * Reminder to submit authorization requests via the PWP * Therapy Assistants and Athletic Trainers * Affirmative Statement about UM Decision Making
Devoted Expansion
12/28/2020
Effective JANUARY 1, 2021 American Therapy Administrators of Florida/Health Network One (ATAFL) will be the mandatory specialty network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting (i.e. POS 11), for Devoted Health’s expansion counties for Medicare enrolled members.
2020 Q3 Newsletter
10/27/2020
ATA of Florida's newest newsletter is out. In this edition you will find: * Demographic Changes or Provider Termination Requirements * Required Annual Provider Training * Affirmative Statement about UM Decision Making * Relaxing telehealth regulations does not mean relaxing fraud enforcement * Annual Quality Improvement Documents * Clinical Practice Guidelines * COVID-19 Relief Help * Fraud, Waste & Abuse
Demographic Changes or Provider Termination Requirements
10/26/2020
As needed, ATAFL, Health Plans, and Federal agencies perform ad hoc provider practice “mystery shopper” calls or site visits to measure variables including but not limited to provider roster accuracy; urgent, and routine appointment availability; currently accepting new enrollees, and any barriers to scheduling appointments experienced by enrollees.
Aetna Better Health Healthy Kids COPAY Waiver
10/14/2020
The purpose of this notice is to provide you with an update on Florida Healthy Kids (FHK) copay information for members that are enrolled with Aetna Better Health of Florida (ABHFL) plan. We would like to inform you that effective immediately, ABHFL will waive copayments for Speech, Physical and Occupational Therapy services rendered through December 31, 2020. Copayments will resume January 1, 2021.
New Provider Relations Representative
08/21/2020
Great news! Our Provider Relations Team is growing so that we may continue to provide you and your team with the support that you need. Your new Provider Relations Representative is Paula Powell and her contact details are located below; you are in great hands! Please feel free to contact Paula for all of your contracting and contract maintenance needs.
2020 Q2 Newsletter
06/30/2020
ATA of Florida's newest newsletter is out. In this edition you will find: * Free HIPPA Compliant Telehealth available to all ATA-FL providers * Telemedicine Guidance and Attestations * COVID-19 Relief Help * Relaxing telehealth regulations does not mean relaxing fraud enforcement * Fraud, Waste & Abuse * Annual Quality Improvement Documents * Clinical Practice Guidelines
Important Funding Announcement For All Medicaid Providers
06/19/2020
For all Medicaid and CHIP providers: The U.S. Department of Health and Human Services (HHS) has announced additional distributions from the Provider Relief Fund to eligible providers that participate in the Medicaid and Children’s Health Insurance Programs.
COVID-19 Protection Protocols
06/19/2020
As providers considered opening up their offices, ATA-FL has put together a COVID-19 protection protocol document to assist you and your staff to navigate the numerous safety measures that are recommended for medical offices
Medicaid Telemedicine Guidance & Attestation
01/05/2020
Effective immediately, American Therapy Administrators of Florida (ATAFL) shall reimburse Speech Therapy, Physical Therapy and Occupational Therapy services which apply to services through the Statewide Medicaid Managed Care program and the Florida Healthy Kids program.
Medicare Telemedicine Guidance & Attestation
01/05/2020
Effective March 6, 2020, American Therapy Administrators of Florida (ATAFL) shall reimburse Speech Therapy, Physical Therapy and Occupational Therapy services for services described herein which apply to services rendered to Medicare and Market Place (Commercial) enrollees.
Aetna Better Health of Florida Healthy Kids Expansion
01/05/2020
Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for ...
Simply Health Plan Healthy Kids Expansion
01/05/2020
Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for ...
2019 Q4 Newsletter
12/31/2019
Our latest newsletter is out. In this edition you will find: Important Claims and Billing updates, New Health Plan Implementation — CarePlus, New Health Plan Implementation — Community Care Plan, Profound level of impairment definition, Fraud, Waste and Abuse, Referring Provider NPI for Medicaid, Annual Quality Improvement Documents, Clinical Practice Guidelines and Demographic Changes or Provider Termination Requirements
New Health Plan Implementation — CarePlus
12/31/2019
Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for CarePlus’ Medicare enrolled members.
New Health Plan Implementation — Community Care Plan
12/31/2019
Effective JANUARY 1, 2020 American Therapy Administrators of Florida/Health Network One (ATAFL/HN1) will be the mandatory specialty network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a freestanding Facility or office setting (i.e. POS 11), for CCP’s Medicaid and Healthy Kids enrolled members.
2019 Q3 Newsletter
09/30/2019
Our latest newsletter is out. In this edition you will find: Profound level of impairment definition, FMMIS checking NPI numbers on all claims, Fraud, Waste & Abuse, Annual Quality Improvement Documents, Clinical Practice Guidelines and Demographic Changes or Provider Termination Requirements
Provider Changes or Terminations Requirements
09/30/2019
Participating practices are required to notify ATA-FL immediately when: A Therapist employee has been terminated or is no longer treating patients at a specific location** or A location is closing or relocating
FMMIS to check NPI is present on all Claims
08/02/2019
Effective August 15, 2019, the Florida Medicaid Management Information System (FMMIS) will begin checking that the National Provider Identification (NPI) number for referring, ordering, and attending providers is present on fee-for-service claims and encounter submissions. This requirement is applicable for claims and encounters that include a date of service on or after August 15, 2019.
Molina - New Health Plan Implementation — Medicaid
07/02/2019
Effective July 1, 2019 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting (i.e. POS 11).
Molina - New Health Plan Implementation — Medicare & Commercial
07/02/2019
Effective July 1, 2019 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting (i.e. POS 11).
Encounter Data Submission Requirements
05/30/2019
Providers are required to submit claims encounters for all services rendered. Each and every visit and service are to be reported in the form of a claim to ATA-FL. This claim encounter ensures that the Plan’s members are receiving therapy services as authorized by ATA-FL per the POC.
Our Provider Web Portal and Its Security Features
05/01/2019
HS1 will assign the primary, or Account Owner, account. The Account Owner creates and assigns any other usernames for additional staff members. Employees should never share their credentials – each user should have their own username! Account credentials should not be shared amongst staff.
New Health Plan Implementation
03/06/2019
American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing outpatient setting (i.e. POS 11), for Aetna Better Health® of Florida Medicaid enrolled members of all ages.
Aetna Better Health of Florida Healthy Kids Expansion
03/06/2019
American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing outpatient setting (i.e. POS 11), for Aetna Better Health® of Florida Healthy Kids enrolled members in the expansion counties listed below.
Human Trafficking Training
02/21/2019
Attached please find our Human Trafficking Training PDF. This is an important issue for Florida, and creating awareness is key. We thank you in advance for helping us get this important information out there to you and your staff.
NON-PAR Provider Authorization Requests
01/31/2019
Non-Participating providers SHALL NOT EVALUATE, re-evaluate or treat beneficiaries managed by ATA-FL UNTIL THEY ARE CREDENTIALED by ATA-FL .....
Healthcare Alert - COC and Auth Requests
01/25/2019
As the Agency for Health Care Administration (the Agency) continues to transition Statewide Medicaid Managed Care (SMMC) enrollees as part of the SMMC Health and Dental Plan regional phased roll-out, providers are reminded of the SMMC Continuity of Care (COC) provision .....
Reminder to submit claims for all dates of services rendered
11/16/2018
HN1/ATA-FL is required to submit Encounters to each Health Plan for each claim that is received by a contracted provider. Why are Encounters so Important? Without a record of your claims encounter, it is as if the beneficiary never received the service from you .....
Critical Elements Required for Authorization Requests
09/17/2018
All treating providers must submit the following elements with each authorization request .....
2018 Q2 Newsletter
08/03/2018
ATA-FL's latest edition of our Provider Newsletter is out. In this issue you will find the following articles: * New Medicare Line of Business Health Plan;* New Medicaid LOB Health Plans; * Humana Medicaid termination date has been lifted; * Annual Quality Improvement Documents; * Our New Enhanced UM Model; * The Four Critical Elements * Schedule Your Training.
New Medicaid LOB Health Plans — Better Health, Clear Health Alliance, and Simply Healthcare Plans
06/29/2018
Effective July 1, 2018 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing facility or office setting (i.e. POS 11), for Better Health, Clear Health, or Simply Healthcare Medicaid enrolled members.
Simply Healthcare - New Medicare LOB Health Plan
06/29/2018
Effective July 1, 2018 American Therapy Administrators of Florida / Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or setting (i.e. POS 11), for Simply Healthcare Plan’s Medicare enrolled members.
UPDATE on our New Enhanced UM Model
04/12/2018
The Enhanced Utilization Management Model effective date has been changed to 6/1/2018. Our enhanced Utilization Management Model will reduce the administration burden for our provider network from multiple submissions of similar documentation to one submission per episode care.
Humana termination has been lifted
02/09/2018
Effective immediately, providers participating in the ATA-FL network in regions 6, 9, 10, and 11 may continue rendering services to Humana Medicaid beneficiaries. All authorization requests and claims payments will continue to be processed by ATA-FL ....
Provider Web Portal Updates
05/30/2017
We are pleased to announce the upcoming release of a new version of the Provider Web Portal (PWP). Available June 1, 2017, the new version will have a new look and new functionality that will allow you to be more effective, selfsufficient and paperless....
Q4 Newsletter
02/13/2017
Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ...
On 12/31/16 4-code set (97001-97004) will terminate
12/21/2016
Effective 12/31/2016 the 4-code set (97001-97004) for Physical Therapy (PT) and Occupational Therapy (OT) evaluative procedures will terminate ...
Address Updates: Wonderbox PWP URL & PO BOX for Paper Claims
11/9/2016
Effective November 7, 2016 the Provider Web Portal will have a new web address https://ata.therapyadmin.com/pwp. This will be the URL for you to use to access remittance statements, submit claims, view status of any claims and Patient Responsibility letters dated November 7, 2016 or later. ...
Wonderbox Provider Web Portal New Web Address
11/4/2016
This information is intended only for Coventry/Aetna Commercial & Coventry Medicare — The Wonderbox Provider Web Portal, which administers Coventry/Aetna Commercial & Coventry Medicare will have a new web address https://ata.therapyadmin.com/pwp. This will be the URL ...
Claim and Encounter Data Submission
08/15/2016
HN1/ATA-FL is required to submit Encounters to each Health Plans for each claim that is received by a contracted provider. Why are Encounters so Important?
Revised Documentation Requirements
08/10/2016
Important Changes That Will Impact Your Authorization Requests. UM Department will begin reviewing claim Encounter submissions prior to issuing a Step 2, Step 3, or an Upgrade and Documentation Requirements for Therapy Services - Plan of Care, Daily Visit Note & Therapy Service Discharge.
2016 Q2 Newsletter
06/29/2016
Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ....
Documentation Requirements
06/22/2016
Important Changes That Will Impact Your Authorization Requests. UM Department will begin reviewing claim Encounter submissions prior to issuing a Step 2, Step 3, or an Upgrade and Documentation Requirements for Therapy Services - Plan of Care, Daily Visit Note & Therapy Service Discharge.
Encounter Submissions
06/22/2016
2016 Q1 Newsletter
04/11/2016
Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ....
Winter Edition 2016 Newsletter
02/05/2016
Our current newsletter is out and contains information about our network, reminders and other topics. Our newsletter is usually published once a quarter ....
MMA Express Enrollment NOW Effective
02/03/2016
The State received approval of an amendment to Florida’s 1115 MMA Managed Medical Assistance waiver to allow for Express Enrollment beginning ....
Intake form and Pre-Service Determination Letters
01/07/2016
Effective Immediately the Intake Form must be completed in its entirety in order to be accepted for Authorization approval. Intake forms that are not entirely filled out will be returned back to ....
Migrating to 2 Separate Platforms
11/19/2015
Effective 12/01/2015, claims and referral administration for Sunshine Health Plan’s MMA and Child Welfare (CW) products and Coventry/Aetna health Plan’s Commercial/Medicare and Medicaid/Healthy Kids (HK) .....
Cover Home & School
07/27/2015
Effective August 1st, 2015, for members enrolled in Sunshine Health Plan, American Therapy Administrators of Florida (ATA-FL/HN1) will cover therapy services in the home (POS 12) and school (POS 03) .....
New Intake Form
07/09/2015
Enclosed for your review and immediate use is the NEW ATA-FL Patient Intake Form. Please replace the current form that you are using with this NEW form effective immediately. The form is updated to provide .....
Sunshine Notice
03/31/2015
Effective April 1, 2015 American Therapy Administrators of Florida/Health Network One (ATA-FL/HN1) will be the mandatory specialty network for physical therapy, speech therapy and occupational therapy services provide .....