Behavioral Analysis (BA) Services
Florida Community Care (FCC) is committed to helping BA providers navigate its billing process which was established to meet the Agency for Health Care Administration’s requirements for BA providers and FCC.
This page provides billing and reimbursement guidance for Behavioral Analysis (BA) services, including claims submission and payment guidelines during the continuity of care period, as outlined by the Agency for Health Care Administration in the Continuity of Care Program Highlight.
Eligibility
Providers may verify Enrollee eligibility in the following ways:
Billing and Reimbursement During the Continuity of Care (COC) Period
FCC will honor any ongoing service, or routine appointments scheduled prior to enrollment, including prior authorization for behavioral analysis services for the entirety of the continuity of care period for a minimum of 120 days after the effective date of enrollment.
FCC will extend any existing prior authorizations that may expire during the continuity of care period for the remainder of the continuity of care period.
FCC will reimburse non-participating providers at the rate they received for services rendered to the enrollee immediately prior to the enrollee transitioning for a minimum of 90 days, unless the provider agrees to an alternative rate.
Submission of Electronic and Paper Claims:
Providers can submit electronic claims to FCC via the provider’s clearinghouse or FCC’s clearinghouse, Availity, using Payer ID FLCCR.
For information about electronic claims or to register with Availity visit FCC’s website: Availity Essentials Secure Provider Portal Registration.
Paper claims may be mailed to: Florida Community Care Attn: Claims PO Box 211322 Eagan, MN 55121
For assistance with claims submission, contact FCC’s Provider Call Center at: 1.833.322.7526.
Process and Timeline for Reimbursement:
Upon receipt of a clean claim, providers can expect to receive reimbursement within 15 days, but most providers will be reimbursed within 7 days. A clean claim is a claim that can be processed without obtaining additional information from the provider or from a third party.
Prior Authorization
Requests for prior authorization for new courses of treatment and services after the COC period should be submitted to FCC’s Utilization Department using the Florida Community Care ABA Prior Authorization Request Form.
Requests can be submitted in the following ways:
Providers can view a complete list of services that require prior authorization on FCC’s website, at Florida Community Care Prior Authorization Program.
For assistance with prior authorizations, contact FCC’s Provider Call Center at 1.833.322.7526.
EFT/ERA Enrollment
To register for Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA), submit the appropriate forms located here: For Providers - Florida Community Care.
Requests can be submitted in the following ways:
- FCCEFT@FCCHealthPlan.com
- Fax: 631.963.4935
Additional Billing Resources:
FCC’s provider handbook includes additional information relating to FCC’s billing process.
FCC’s Secure Web Portal offers several self-serve functions including:
Enrollee Eligibility Status
Authorization Status or Requests
Claims Status
Provider Inquiry Request
To register for the Provider Portal, follow this link Florida Community Care Provider Portal, and select Provider User Account Sign Up.
Joining FCC’s Network:
Behavioral Services Network (BSN) is FCC’s behavioral health partner. Providers interested in joining FCC’s network may submit a request for network participation on BSN’s website at: https://providers.bsnnet.com/auth/register
Need Help?
Florida Community Care is a Managed Care Plan with a Florida Medicaid Contract.
The benefit information provided is a brief summary, not a complete description of benefits. For more information contact FCC. Limitations, co-payments, and/or restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change. Enrollment Broker/Choice Counseling: 1.877.711.3662 — TDD: 1.866.467.4970
FCC complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.
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