12.06.2018 Sunshine Insurance Contract | Pediatricians in Tampa Bay | Offices in Hillsborough, Pasco, and Pinellas

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12.06.2018 Sunshine Insurance Contract

**12/2018 REMINDER** Please read the following information if your child's insurance plan is Sunshine Health. We will be sending this information to our patients via mail, text, and email several times prior to the Feb 2019 deadline, in an effort to ensure our patients are well-informed about the situation. 

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Dear Parents and Patients,

In November, we were informed that Sunshine Health is amending our contract with them. This means that patients insured with the Sunshine Health Plan will no longer be able to visit Pediatric Health Care Alliance, PA (PHCA). The contract changes will take effect February 16, 2019. We apologize for the short notice, but it was not our decision.

As a single-specialty group, we are focused exclusively on quality pediatric care for children in Tampa Bay. Our network of services includes 12 locations with over 50 pediatricians and providers, evening and weekend hours at many locations, and NCQA certification as a Patient-Centered Medical Home.

As explained below, you may be able to continue visiting PHCA for primary care pediatrics, if you elect to become insured with another Medicaid MMA plan accepted by PHCA.

What You Can Do

à Change Your Plan

You may be eligible to change to another Medicaid MMA plan that is accepted by PHCA. We accept:

  • Simply Health (formerly Amerigroup)
  • Staywell

If you so desire, please contact Florida Medicaid immediately to request a plan change today, which may ensure there is no interruption to your pediatric care from PHCA. Please state that your current provider will no longer be part of the Sunshine network and that this should qualify as a GC9: ”a state approved good-cause reason” to request a change to your plan because you have an “established provider relationship.”

Please contact Florida Medicaid for your options and further information:

Choice Counseling Department
1 (877) 711-3662

Mon-Thurs 8:00am - 8:00pm | Fri 8:00am - 7:00 pm

https://www.flmedicaidmanagedcare.com/

 

à Express Your Concern to Sunshine Health

You may also choose to contact Sunshine and share your thoughts about the contract changes. If you so choose, you may use the following contacts for Sunshine to express your thoughts about future access to your PHCA pediatrician:

Mark Barrett, Senior Vice President
mbarrett@centene.com
1 (866) 796-0530 ext. 41342

or

Kristy Shulthiess, Senior Contract Negotiator
kshulthiess@centene.com
(813) 286-6128 or 1 (866) 796-0530 ext. 41328

 

At this time, we do not anticipate any other changes with Sunshine Health, but we will make every effort to reach out to our patient families immediately if the status of our contract changes. As always, our primary concern is the health, well-being, and continuity of care for our patients. Thank you.

Sincerely,

Karalee Kulek-Luzey, MD
Medical Director