Welcome to Better Health’s Medicaid Reform Provider Network. We are pleased that you have decided to participate in our plan specifically for Medicaid Members.
Better Health takes a positive approach toward managing Medicaid Members by working collaboratively with their Primary Care Physician to support a system of optimal utilization management and clinical quality. We believe that this system of management is the formula for our mutual success.
Interested in becoming a Better Health Provider? Contact us at: (800) 514-4561.
For membership eligibility verification, call our Automated Information System at (877) 915-0551
Florida Medicaid Preferred Drug Program:
Click here for more detailed info.
The preferred method of claims submission is electronic. Please see the instructions below.
- Preferred vendor is Emdeon using payer id 20488
Send all paper claims to:
Better Health, LLC
PO Box 211665
Eagan, MN 55121
Better Health Quick Reference Guide Click here for more detailed info
Provider Manual: Click here for more detailed info.Provider Forms
- Better Health Referral/Authorization Form
- Medical Release Form
- Expectant Mother Notification Form
- Abortion Certification Form
- Sterilization Consent Form
- Domestic Violence Assessment Tool
- Better Health ID Card
- Request for Change of Member Information Form
Helping Smokers Quit: Click here for A Guide for Clinicians.
Asthma Quick Care Reference Guide: Click www.nhlbi.nih.gov
For information about diabetes, Click http://www.diabetes.org.
Fraud/Waste/Abuse Help Us Stop Fraud, Waste and Abuse
Better Health wants you to get the respect you deserve and the service you expect. When fraud and abuse happens, it hurts you, your doctors and everybody in the health care system.
- Fraud - An intentional deception or misrepresentation made by a person or entity with the knowledge that the deception could result in some unauthorized benefit to him/herself, itself or some other person or entity. It includes any act that constitutes fraud under applicable federal or state law.
- Waste - An intentional or unintentional, thoughtless or careless expenditures, consumption, mismanagement, use, or squandering of resources; to the detriment or potential detriment of entities, but without intent to deceive or misrepresent.
- Abuse - Behaviors or practices of providers, physicians, or suppliers of services and equipment that, although normally not considered fraudulent, are inconsistent with accepted sound medical, business, or fiscal practices. The practices may, directly or indirectly, result in unnecessary costs to the program, improper payment, or payment for services that fail to meet professionally recognized standards of care, or which are medically unnecessary.
Things You Can Do to Stop Fraud, Waste and Abuse:
- When you receive a bill or Explanation of Benefits (EOB), look at it closely. Check to see if the services on your bill are the ones you actually received. Make sure the date of your visit is correct.
- Never give out or let anyone borrow your Better Health Member ID number.
- Do not share your medical records with anyone except your primary care provider (PCP), hospital or health plan.
- Never ask your PCP for medical services or medicines you do not need..
- If someone offers you free tests or services using your Better Health Member ID card, beware! If you think it sounds too good to be true, you are probably right. Call member services 1-877-577-9043 for more information.
Remember, committing fraud is against the law. One way to stop it is to report it. To report suspected fraud, waste or abuse, call our Confidential Compliance and Fraud, Waste & Abuse Hotline at 1-877-253-9251 or you may email us, SIU@simplyhealthcareplans.com. Please click here to filled out a confidential FWA referral form.