Published Date: Dec 05, 2022
Effective JANUARY 1, 2022, Therapy Network of Florida (TNFL) will be the mandatory specialty network for outpatient physical therapy, speech therapy, and occupational therapy services provided in a free-standing facility or office setting (i.e., POS 11) for Devoted Health's expansion counties for Medicare-enrolled members.
Medicare Expansion Counties
Volusia, Flagler, Brevard, Indian River, St. Lucie, Martin, Escambia, Santa Rosa, and Okaloosa Counties.
Continuation of Care (COC)
Continuation of Care (COC) period is up to 30 days from the date the member switched to Devoted Health Medicare from another Medicare Advantage plan. The COC period ends when the old authorization expires or when the 30 days ends, whichever comes first. You are not required to obtain an authorization from TNFL to continue providing these services during the Continuation of Care Period. If you are NOT a participating provider with TNFL, please refer the member to their primary care physician or ordering physician so that they may refer the member to a participating therapist. Members may also contact the health plan to locate a participating therapist.
Provider Manual
Find the TNFL Devoted Health Provider Manual on our website under provider resources at https://mytnfl.com/ provider-resources.php.
How to Receive Payment For Services Post COC Period
All rendering providers must request a payment control number. You may request a payment control number by submitting the following critical elements via our provider web portal at mytnfl.com/hs1portal. Faxing is available as an emergency backup; call 1-855-410-0121. All forms are available on our website at https://mytnfl.com.
- Prescription or Referral Form (N/A for reevaluations)
- Evaluation;
- A new POC/evaluation must be signed by the treating Therapist;
- An expired POC from the certification period that just ended must be signed by the treating Therapist and referring provider(Physician/ARNP/ P.A./Chiropractor).
- A POC with diagnosis signed/dated by the referring provider (Physician/ARNP/P.A./Chiropractor) and, or a Letter of Medical Necessity (LMN).
- The Plan of Care must include the evaluation and the start and stop dates.
- The Plan of Care must include the signature of the referring provider (Physician/ARNP/P.A./ Chiropractor) recorded on or afterthe recorded date of the treating therapist’s signature.
- The therapist that develops the POC must sign and date the document on its completion date. The therapist must sign and date the POC before the PCP’s signature and date. The PCP may sign and date the POC on the same date the therapist signs and dates the POC.
- Assessment Scores should be clearly denoted
CRITICALLY IMPORTANT: If any of the above elements are missing, TNFL will not be able to issue a payment control number.
Claims Submission
If the member's previous health plan issued you an authorization for a service date on or before 12/31/2022, please submit your claims directly to the previous plan for DOS on or before 12/31/2022.
For DOS on or after 1/1/2023, please submit your claims to TNFL at P.O. Box 350590, Fort Lauderdale, FL 33335-0590, or submit your claims electronically using Electronic Data Interchange (EDI) via Professional Payer ID 65062 or Institutional Payer ID 12k89. Along with your submittal of claims, providers are required to submit written documentation such as prior existing orders, prior authorizations and treatment plan/plan of care to receive payment on their claim under continuity of care.
Patient Responsibility
Providers may confirm co-pays, deductibles, co-insurance, and MOOP details through Availity's website at https:// apps.availity.com/availity/web/public.elegant.login or via our provider web portal at https://asp.healthsystemone. com/hs1providers.
For any questions regarding patient responsibilities, please contact Devoted's provider services department at 1-877-762-3515 or contact TNFL Provider Relations at 1 (888) 550-8800 Option 2.