Children's Medical Services Health Plan
MedicaidAlso covers: CMS Health Plan, CMS Managed Care Plan
Payer ID
68069
Administered by Sunshine Health (Centene), so it bills under Sunshine Health's payer ID 68069 and rules.
Timely Filing Limit (TFL)
180 days from date of service (Sunshine Health rules)
Appeal Window
Claim reconsideration/adjustment 90 days from notification of payment or denial
Clearinghouse
Availity / Centene EDI (payer ID 68069)
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Sunshine Health, Attn: Adjustments/Reconsiderations/Disputes, PO Box 3070, Farmington, MO 63640-3823
Provider Portal
https://www.sunshinehealth.com/members/cms.html
Specialty plan for children with special health care needs; administered by Sunshine Health. As of 7/1/2025 CMS enrollment transferred to AHCA — confirm current administration.
Values vary by plan, region, and contract and can change. Confirm in the payer portal or with your clearinghouse before filing.
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