Ambetter from Sunshine Health has contracted with CareCentrix

Date: 08/11/21

Effective Oct. 1, 2021, Ambetter from Sunshine Health has contracted with CareCentrix to manage post-acute care services for our Ambetter members in Florida.

Here are the key details:

• CareCentrix will manage authorization reviews for members who are admitted to skilled nursing facilities, inpatient rehabilitation facilities and long term acute care hospitals.
• CareCentrix will support care coordination to connect a patient’s journey across the continuum, identifying paths for care that help optimize clinical outcomes.
• CareCentrix will provide nurse coaching for patients identified for intervention at home after an acute care hospital discharge for up to 90 days to support their path to healing, reduce unnecessary readmissions, and help members achieve self-management.
• Ambetter from Sunshine Health will continue to manage authorizations for all other services.
• Ambetter from Sunshine Health will continue to manage claims and appeals for all services.

CareCentrix will contact you shortly to provide information and training regarding the post-acute program and new authorization so you are well informed by Oct. 1, 2021.

If you have questions, please call provider services at 1-877-687-1169 or contact your provider representative.