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№ 01 SERVING FL

Medical Billing Services in Florida

MedPrecision partners with Florida practices navigating one of the fastest-growing healthcare markets in the U.S. Florida Medicaid operates through managed care plans like Sunshine Health, Humana, and Aetna Better Health, each with different prior auth requirements and formulary rules. The state's large Medicare Advantage population means practices must manage both traditional Medicare and MA plan billing — with different reimbursement timelines and appeals processes. From Miami to Jacksonville to Tampa, payer mix varies significantly by region.

65,000+
Licensed Physicians
Active licensed physicians in Florida as of 2024
5.5M
Medicaid Enrollment
Florida Medicaid Managed Medical Assistance enrollment
56%
Medicare Advantage Penetration
Florida leads the nation in Medicare Advantage enrollment as a share of Medicare beneficiaries
120+
Practices Served
MedPrecision clients across the state of Florida

MedPrecision serves private practices, specialty groups, clinics, and telehealth providers across Florida. Our remote billing model provides the same dedicated support whether you are in Jacksonville, Miami, Tampa or anywhere else in the state.

The Florida Billing Landscape

Florida's medical billing landscape is defined by its massive Medicare and Medicare Advantage population — the state leads the nation in MA penetration, with plans from Humana, UnitedHealthcare, Devoted Health, and Aetna dominating the senior market. This means Florida practices must master MA-specific prior authorization rules, risk adjustment coding (HCC), and narrow network requirements that differ significantly from Original Medicare. Florida Medicaid operates through Statewide Medicaid Managed Care with plans including Sunshine Health (Centene), Molina, Humana, and Simply Healthcare. The commercial market is led by Florida Blue (BCBS), UnitedHealthcare, Aetna, and Cigna. Florida's prompt pay law under Florida Statute 627.6131 requires clean claims to be paid within 20 days for electronic submissions with penalty interest on late payments. The state has no income tax, attracting a steady influx of new practices, but competition for patients is fierce in metro areas like Miami, Tampa, and Orlando. South Florida's diverse population creates multilingual billing needs and high Medicaid enrollment. Rural Panhandle and Central Florida practices face lower reimbursement rates and higher uninsured populations. Florida mandates telehealth coverage but does not require full payment parity, creating per-payer negotiation dynamics.

Who We Serve in Florida

Solo Practices Group Practices Medicare-Heavy Practices Urgent Care Centers Telehealth Providers

Major Metro Areas Served

Jacksonville Miami Tampa Orlando St. Petersburg Fort Lauderdale

Payer Landscape in Florida

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Medicaid Program

Florida Medicaid (Statewide Medicaid Managed Care - SMMC)

Managed Care Organizations

Sunshine HealthHumana Medical PlanAetna Better HealthMolina HealthcareSimply HealthcareCommunity Care Plan
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Key Commercial Payers

Florida Blue (Blue Cross Blue Shield of Florida)UnitedHealthcareAetnaCignaHumana
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Timely Filing Deadlines

Medicaid365 days
Commercial Payers90-180 days
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Prompt Pay Law

Florida Statute 627.6131 requires insurers to pay clean electronic claims within 20 days and paper claims within 40 days. Penalties include 10% annual interest plus $10 per day per claim.

How Remote Onboarding Works

01

Discovery Call

We learn about your Florida practice, current billing setup, and pain points.

02

Billing Audit

A complimentary review of your recent claims, denials, and A/R aging.

03

Workflow Transition

Direct integration with your EHR/PM system — no disruption to patient care.

04

Ongoing Reporting

Monthly performance reports with actionable insights to keep collections growing.

Florida Billing Regulations & Compliance

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State Insurance Regulator

Florida Office of Insurance Regulation (OIR)

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Surprise Billing Protection

Florida HB 221 (2016) provides surprise billing protections for emergency services and non-emergency services at in-network facilities. The federal No Surprises Act adds additional protections.

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Telehealth Billing Parity

Florida requires Medicaid to cover telehealth services. Commercial telehealth parity was expanded under SB 1606, requiring coverage of telehealth on the same basis as in-person services.

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Common Questions

Common questions about medical billing services in Florida.

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How do you handle Florida Medicaid managed care?

Florida Medicaid runs through Statewide Medicaid Managed Care plans including Sunshine Health, Humana, and Aetna Better Health. Each plan has its own prior auth requirements, timely filing limits, and appeals processes. Our team manages the specifics for each.

What about Florida's large Medicare Advantage population?

Florida has one of the highest MA penetration rates in the country. We bill both traditional Medicare and MA plans like Humana, UHC, and Devoted Health — and manage the different reimbursement timelines and appeal windows for each.

Do you handle billing for practices across Florida?

Yes — from Miami-Dade and Broward to Tampa Bay, Orlando, and Jacksonville. Each region has a different payer mix, and our team adjusts billing strategies accordingly.

How do Florida's prompt payment laws work?

Florida Statute 627.6131 requires insurers to pay clean electronic claims within 20 days and paper claims within 40 days. We track every claim against these timelines and escalate when payers are non-compliant.

№ 99 The Closing Argument

Get a Free Billing Audit

See where denials, follow-up delays, or workflow gaps may be hurting your Florida practice's collections.

Free · No obligation · Typical audit 3–5 days &