News & Ad Hoc announcements

New Health Plan Implementation — AvMed Medicare

Published Date: Jun 27, 2022

Effective July 1, 2022, Health Network One's Therapy Network of Florida will be the mandatory network for Outpatient physical therapy, speech therapy and occupational therapy services provided in a free-standing Facility or office setting, for AvMed's Medicare enrollees.

Medicare Coverage Area

Miami-Dade and Broward Counties

Service Exclusions

Tertiary or medically fragile cases, Hospital based and/or Inpatient Therapy, Home Health, Partial Day Rehabilitation, Spinal Cord Injuries, Non-traditional free-standing rehabilitation Therapy services including, but not limited to hippo therapy, art therapy, music therapy, vision therapy, aquatic therapy, ABA and cognitive therapy are not covered by TNFL. Our UM team will assist providers in referring any patients identified as such to the health plan.

Patient Responsibility

Providers may confirm co-pay, deductible, co-insurance and MOOP details through Availity at www.availity.com. For any questions regarding patient responsibilities, please contact

How to receive payment for services

All rendering providers MUST request a Payment Control Number. You may request a payment control number by submit the following Critical Elements via our Provider Web Portal at mytnfl.com/hs1portal. However, fax is available as an emergency backup via TNFL fax at 1-855-410-0121.

  1. Prescription or Referral Form (N/A for reevaluations)
    • Evaluation;
    • New POC/evaluation must be signed by the treating Therapist;
    • Expired POC from the certification period that just ended must be signed by the treating Therapist and referring provider (Physician/ ARNP/P.A./Chiropractor).
  2. POC with diagnosis signed/dated by the referring provider (Physician/ARNP/P.A./Chiropractor) and/ or 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 after the recorded date of the treating therapist's signature.
    • The therapist that develops the POC must sign and date the document on the date it is completed. The therapist must sign and date the POC prior to 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.
  3. Assessment Scores clearly denoted.

CRITICALLY IMPORTANT: If any of the above elements are missing, TNFL will not be able to issue a payment control number

Provider notification of Payment Control Number

Via the Provider Web Portal at mytnfl.com/hs1portal