- Insurer Name : Simply Healthcare Plans
- Address : 9250 W Flagler St, Miami, FL 33174
- Phone Number : 1-844-405-4296
- Website : https://www.simplyhealthcareplans.com/
- Medicare/Medicaid/TRICARE Support : Yes (Medicare, Medicaid)
- Specific Plans Offered : Offers Medicare Advantage plans and Medicaid plans. Simply Healthcare Plans
Frequently Asked Questions:
What is pre-authorization?
Pre-authorization, also known as prior authorization, is the process where Simply Healthcare evaluates medical history and information from healthcare providers to determine if a requested service is medically necessary and covered under your plan. simplyhealthcareplans.com
When is pre-authorization required?
Pre-authorization is required for certain medical services and prescription drugs, especially when there are generic alternatives, potential for misuse, or if the drug has high side effect potential. simplyhealthcareplans.com
How can my doctor submit a pre-authorization request?
Your doctor can submit a pre-authorization request to Simply Healthcare by fax at 1-877-577-9045 or by phone at 1-877-577-9044, including a Request for Coverage Determination Form. simplyhealthcareplans.com
What happens if I don't obtain pre-authorization?
If pre-authorization is not obtained for services or medications that require it, Simply Healthcare may not cover the cost, and you could be responsible for the full payment. simplyhealthcareplans.com
Are there services that do not require pre-authorization?
Yes, for example, COVID-19 testing does not require pre-authorization. simplyhealthcareplans.com
Who can I contact for questions about pre-authorization?
For questions about pre-authorization, you can contact Simply Healthcare's Member Services at 1-877-577-0115 (TTY: 711). simplyhealthcareplans.com
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