Attention PAC Waiver Providers

PAC Waiver has transitioned to Managed Care, effective January 1, 2018. For additional information, please visit the Agency’s website for information on Florida Medicaid’s PAC Waiver Changes :Florida Medicaid PAC Waiver changes (Click Here)

Attention Home Health Providers

Home health administrators, directors of nursing, billing staff, as well as other designated individuals are encouraged to attend training on the Electronic Visit Verification (EVV) System.

Please visit the EVV Training page to sign up for training session date(s) and time(s) that best fits your schedule.

Hurricane Irma Update from eQHealth Solutions:
Given the recent events of Hurricane Irma, we would like to share that eQHealth Solutions is fully operational at this time.  

We are working closely with AHCA to ensure that your needs are met, and we invite you to notify us immediately should you encounter any difficulties with our systems or processes. Please dial 855-444-3747 for Customer Support.

Our thoughts go out to those affected by Hurricane Irma, and we’re committed to providing you with the support you need during recovery

Hurricane Irma - Message from AHCA:
Click Here

Attention DME Providers-Recipients over the age of 21

When requesting authorization for a DME item please make sure you are referencing the Florida Medicaid Fee Schedule for the appropriate HCPCS Code.  We have recently seen an increase of reviews submitted with the A9900 code.  Please note A9900 is a -Misc DME Supply, accessory, and/or service component of another HCPCS Code .

(Example: briefs, diapers, protective underwear, pull-ons, liners, shields, guards, pads, wipes and undergarments)

You can reference the FL DME Imitations Handbook for additional information pp2-8.

PDN and PCS Providers

There have been recent changes to the Florida Medicaid Policy for Personal Care Services and Private Duty Nursing.   You can find this policy by clicking on one of the links below.

FL Medicaid Coverage Policy for Personal Care Services

FL Medicaid Coverage Policy for PDN Services

One of the biggest changes is that you are now be able to request up to 180 days for all admission requests.  Please make sure that if you are requesting 180 days that the prescription for services match your request.

Attention DME Providers

If you are entering a DME request please make sure you are referencing the Florida Medicaid Fee Schedule for Prior Authorization Requirements.  If you do not have a copy of the Fee Schedule you can find them on our website on the following link.  
Florida DME Fee Schedule

Prior Authorization numbers
When referencing the Fee Schedule if the code you are requesting has a “PA” this means the code requires prior authorization and once approved you will receive your authorization letter with a PA#. 

If the code you are requesting only states “Medical Necessity” this means the code requires prior authorization however it does not require a PA #.  This means a PA# will NOT generate when you receive your authorization letter.  To avoid a denial on your claims make sure to include your authorization letter with your claim submission.




eQSuite Login

eQSuite is our proprietary web-based, HIPAA compliant prior authorization system which offers providers 24/7 accessibility to the information they need.

eQHealth Solutions Customer Service:

Monday - Friday (except Florida state recognized holidays)
8:00 am - 5:00 pm (EST)
Phone: 855-444-3747 
Fax: 855-440-3747

Provider Alerts

The Florida Medicaid program has an email alert system that providers can utilize to receive updates on health care information. To register please click on the below link.

FL Medicaid Health Care Alerts









eQHealth Staff Login Only










eQHealth Solutions - Florida Division

The Agency for Health Care Administration (Agency)  entered into a contract with eQHealth Solutions, Inc.  for utilization management, including prior authorization of the following Medicaid services: 

    Inpatient Medical and Surgical Services
    Personal Care Services
    PAC Waiver Services
    Advanced Diagnostic Imaging (ADI)
    Home Health Services 
    Prescribed Pediatric Extended Care (PPEC) Services
    Therapy Services 
    Durable Medical Equipment (DME)
    Dental Services
    Multi-Specialty Services

 eQHealth Solutions, Inc. is a non-profit health care quality improvement, utilization management and health information technology organization, providing a wide range of efficient and effective solutions to our clients.  Services include: prior authorization and  utilization review, care coordination, quality improvement activities, medical record review, health and wellness, and quality review services for home and community based waiver programs. eQHealth Solutions is a market leader in assisting health care providers to adopt  information technology services to improve the quality of care offered to their patients.

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