Florida Medicaid (Fee-for-Service)
Also covers / subsidiaries: FL Medicaid FFS, AHCA Medicaid, FMMIS, Gainwell
Core Payer & Clearinghouse Profile
Electronic Payer ID
10086
No single universal EDI ID — FFS claims route through the FMMIS/Florida Medicaid Secure Web Portal (DDE) or a clearinghouse-specific Florida Medicaid payer ID. Verify per clearinghouse.
Timely Filing Limit (TFL)
12 months (1 year) from date of service; exceptions via AHCA Form 2040 within 6 months of discovery
Appeal Window
Varies — confirm via portal / clearinghouse
Clearinghouse Gateway
FMMIS direct (DDE) or any enrolled clearinghouse
Provider Services
Varies — confirm via portal / clearinghouse
Claims Fax
Varies — confirm via portal / clearinghouse
Claims Address
Varies — confirm via portal / clearinghouse
Provider Portal
https://www.flmmis.com
Administered by FL AHCA with fiscal agent Gainwell Technologies; this is the FFS sliver — most FL Medicaid recipients are in SMMC managed-care plans.
National EDI Clearinghouse Capabilities
Direct ANSI X12 electronic transaction support verified for Florida Medicaid (Fee-for-Service).
Associated Clearinghouse Payer IDs
National clearinghouse networks maintain dedicated routing IDs for specific transaction lines or subsidiaries under Florida Medicaid (Fee-for-Service).
| Clearinghouse Name | Electronic Payer ID | Status | Enrollment | Supported Services |
|---|---|---|---|---|
| Edic | J1289 | Non-Par | None | Workers Comp |
| Edic | WB021 | Non-Par | None | Workers Comp |
| Florida Medicaid | 10086 | Non-Par | None | 837P837I270/271276/277Dental |
| Florida Medicaid | FLMK0 | Non-Par | Required | 837P837I835 ERA |
| Medica | 10125 | Non-Par | None | 837P837I270/271276/277Dental |
| Medica | 94265 | Non-Par | Required | 837P837I835 ERA |
Resolution Tools for Florida Medicaid (Fee-for-Service) Claims
Values vary by plan, line of business, and provider agreement. Confirm in the payer portal or with your clearinghouse gateway before submitting electronic claims.
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