I am owed money for services provided before FHCP was ordered into receivership. What is the procedure for payment of these claims?
The Receiver entered into a contract with a third-party administrator, PayerFusion, to handle the processing of FHCP unpaid claims.
On November 10, 2015 and November 11, 2015, the Receiver sent notices with claim filing instructions to all known medical providers who may have claims unpaid by FHCP. These notices were sent to the email on file with the NPI registry, or by regular mail if no email was available. If you have not received a notice, please contact PayerFusion by email, FHCP@payerfusion.com, or by phone at 888-424-7931. Always include the provider name, tax ID and the NPI in your inquiry.
I have provided services after the company was placed into receivership to a member of FHCP. Who is responsible for paying these bills?
The company, Florida Healthcare Plus, Inc. is responsible for paying services provided under the terms of its member agreements for claims occurring before January 1, 2015. Under Section 641.3154, Florida Statutes, HMO members/subscribers are not liable to any provider of health care services for any services covered by the HMO.
Do I have to submit my unpaid claims to PayerFusion even if I previously submitted them to FHCP?
Yes. The only unpaid FHCP claims that will be processed are those that are submitted to PayerFusion. The Receiver no longer has access to the FHCP claims system.
Can Medical Providers seek payment from former members/subscribers for debt owed by FHCP for medical services?
No. Under Section 641.3154, Florida Statutes, HMO subscribers are not liable to any provider of health care services for any services covered by the HMO. Additionally, health care providers and their representatives are prohibited from attempting to collect payment from the HMO subscribers for such services. If subscribers are contacted by a health care provider for such payment, they should inform the provider of this law.