Thank you to all of our providers who are working tirelessly to care for our members and communities. The safety of our members, doctors and our community is our top priority as we face COVID-19 together. Lighthouse closely monitors updates from the Agency for Health Care Administration and will continue to revise our policies and processes in accordance with the Agency’s direction to help reduce your administrative burdens as you care for patients. We appreciate all you are doing and are here to support you.
~Christie Spencer
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COVID-19 Alerts and Policy Updates
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Lighthouse Health Plan is working diligently to serve our members and support our providers during this unprecedented time. Based on Governor DeSantis’ State of Medical Emergency declaration regarding COVID-19 and the Agency for Health Care Administration’s issued Provider Alerts and policy transmittals, we have compiled Lighthouse’s policy and procedures for our
providers.
We have gathered vital health information disseminated by the CDC and Florida Department of Health to protect our
members and have also developed county-by-county community resources available to help anyone who may be in need of additional support.
Provider Alert System
Several Provider Alerts have been issued by The Agency for Health Care Administration with regard to COVID-19. We are working to provide these alerts on our provider portal for your convenience. You may also sign up for Provider Alerts directly from AHCA and access Provider Alert archives at the following Agency link:
FLMMS Portal
COVID-19 Provider Alerts from AHCA
Access the COVID-19 provider alerts archive
here.
Provider Payment Provisions
At Lighthouse Health Plan we are updating policy and procedures to meet the State guidance and to support our providers. Our website and resources are routinely updated with information available for your review. The information at
our payment provisions page
will help guide you through revised credentialing, administrative, claims and support services policies.
Other Important Links
- Florida Medicaid Web Portal - COVID-19 Information for Providers on the Florida Medicaid Web Portal, which includes the process for provisional provider enrollment
Lighthouse Health Plan Contacts
We are in frequent communication with the Agency for Health Care Administration to receive direction, provide feedback and submit questions for clarification. Please email
providerrelations@lighthousehealthplan.com
if you have questions regarding AHCA directives about COVID-19 we may be able to help answer. You may also contact your provider relations specialist. Our Executive Team is available for your call or email as well.
Thank you for all you are doing for our community and patients. Stay safe and healthy.
Lighthouse Provider Relations
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Provider Visits Suspended Temporarily
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Out of an abundance of caution and in alignment with CDC recommendations, Lighthouse Health Plan's provider relations team members have temporarily suspended in-person provider site visits.
Although we are limiting travel to providers’ offices and curtailing face to face member visits per AHCA guidance,
our teams remain engaged and are available to assist you in this busy time.
For the remainder of March and through April, we will conduct provider visits telephonically. We understand your offices are disrupted and we will work to accommodate your schedules to conduct telephonic visits. Please share your availability at your convenience.
Jennifer Reyes, Provider Relations Specialist
Phone: 210-722-2963
Chrisheila Suarez, Provider Relations Specialist
Phone: 850-480-3987
Kerrie Otano, Provider Relations Manager
Phone: 850-625-9295
Alicia Skolrood, Chief Operating Officer
Phone: 850-390-5003
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Call Provider Services
1-844-243-5181
8 am to 7 pm EST, Mon through Fri
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Lighthouse Care Management Team Activities Update
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Our telephonic care management team continues to provide ongoing support to members through our care management program. In addition to our regular care management activities, all members engaged in care management will be contacted in order to provide education about COVID-19 and reliable resources they can access to remain aware and current (FL DOH and CDC websites). Members are provided information about frequent hand washing, importance of medication refills, and the availability of our 24/7 Nurse line as well as our Teladoc benefit.
Nurse Advice Line
Health Dialog
Phone: (844) 865-7921 (24/7)
Telemedicine
Teladoc
Phone: 1-800-835-2362
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Medical Policy & Procedure Updates
Lighthouse Health Plan has three Medical Policy Updates, which went into affect March 1, 2020:
- Onasemnogene Abeparvovec-axgt (Zolgensma ®)
- Cochlear Implants
- Pain Management
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Claim Verification
To ensure timely processing of your claims, please verify your taxonomy, zip code, and address at the link below.
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Welcome New Providers to the Lighthouse Network
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Creating Little Talkers
Speech Therapy
Tallahassee, FL
904-210-7085
Randall F. Humphreys, MD
Allergy Immunology
2401 St. Andrews Blvd
Panama City, FL 32405
850-785-2717
Roberts Therapy Solutions
Speech Therapy
22404 NE State Road 20
Hosford, FL 32321
850-445-1288
Delisha Leon
Infant Toddler Development Specialist
Fort Walton Beach, FL
850-543-2421
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Meredith Sullivan
Occupational Therapy
Serves Escambia, Santa Rosa, Okaloosa, and Walton
850-509-3923
The PET/CT Imaging Center of Northwest Florida
5149 N 9th Ave., Suite 124
Pensacola, FL 32504
850-478-6336
Speech Language Pathology Services of Tallahassee
Speech Therapy
3330 Capital Oaks Dr.
Tallahassee, FL 32308
850-999-2577
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Meet Dan Sontheimer, MD, Chief Medical Officer
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Dr. Dan Sontheimer, M.D. is Lighthouse Health Plan's Chief Medical Officer. Dr. Sontheimer served as the President of Baptist Medical Group and Chief Transformation Officer and Senior Vice President of Baptist Health Care Corporation. Prior to moving to Pensacola, Dr. Sontheimer was the Chief Medical Officer and Vice President at Cox Health. He earned his medical degree at the University of Kansas Medical School, and completed his residency in Family Medicine in Spartanburg, S.C. He holds a Master of Business Administration from Regis University in Denver, Colorado.
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To View Provider Resources and E-News Archives,
Click Here
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