Authorization Policies for Simply Healthcare Plans, Inc.

Health Provider Website: http://www.simplyhealthcareplans.com/
Accepted Health Plans: Medicaid Healthy Kids

Does the diagnostic service require prior authorization?

MRI: YES*
CT Scans: YES*
PET: YES*
X-rays: NO
Polysonograms: YES
Ultrasounds: NO
Physical Therapy: YES**
Occupational Therapy: YES**
Audio Evaluation: NO
Audio Evaluation: NO
Speech Evaluation: YES**
Feeding and Swallowing Evaluation: YES

*Authorizations for high-end imaging (MRI, CT, PET Scans) are issued by American Imagining Management (AIM). Please contact 1-800-714-0040 to obtain authorization.
**Please note Simply does require pre-certification for rehabilitate evaluations through HN1 for patients under the age of 21. Unfortunately, at this time Nicklaus Children's Hospital does not have a contract with HN1. Please verify with your health plan for an in network provider.

Lab Information

Preferred Independent Lab: LabCorp
Laboratory testing cannot be administered without the required forms. Please bring the LabCorp form (provided by your doctor) to your appointment. Lab Hours of Operation are from 7 a.m. to 3 p.m. Monday through Friday and 7 a.m to 11 a.m. on Saturdays. Labs are closed Sundays. For additional information please call 305-666-6511 ext 1964.


Contact Us

The Authorization Unit can can contacted at 786-624-3022 as well as Managed Care at 305-669-5834 for further clarification.


Please note that some non-employed physicians and credentialed medical staff members of Nicklaus Children's Hospital may not accept all of the health plans listed above. Also note that participation in these plans is not a guarantee of payment or coverage.

This page was last updated on : 7/11/2019 12:02:28 PM.