AHCA Improves Provider Payment Complaints Process

The Agency for Health Care Administration (AHCA) has implemented an improved questionnaire path, for providers who submit a payment-related complaint, using the Agency’s online complaint form.

The new path was developed with input from Medicaid providers and plans, and is intended to:

  • Shorten the time needed to submit a payment-related complaint
  • Offer providers the opportunity to upload a sample EOB/RA of a disputed claim, in lieu of answering additional claims detail questions
  • Collect the information needed to research the complaint at the time of submission.

It is very important to include all requested information at the time the complaint is submitted. Failure to do so may cause delays in processing the complaint.

Access the Medicaid Complaints webpage.

As a reminder, the Agency for Health Care Administration has also developed a web-based resource where providers can check the status of complaint(s). When a complaint is filed, a tracking number is issued. It is important to retain this number. This tracking number allows a provider to check the status of the complaint.

Providers can check the status of all complaints by visiting the Medicaid Complaints webpage at the link above, clicking on the ‘Find your Complaint Status’ and typing the tracking number into the submission box.

The website is refreshed daily to update the status of complaints.  All information is current as of close of business, the prior day.