Florida has the highest Medicare Advantage enrollment rate in the country and a large, complex Medicaid managed care system. RCMAXIS serves Florida practices from Miami to Jacksonville with billing expertise tuned to the state's unique payer environment — including Florida Blue, Molina, Sunshine Health, and all major MA plans.
Florida's healthcare market is unlike any other in the US. With the highest percentage of Medicare beneficiaries, a booming Medicare Advantage market, and Florida Medicaid managed by plans including Molina, WellCare, Simply Healthcare, and Sunshine Health — Florida practices face payer complexity that requires dedicated expertise. RCMAXIS billing teams understand Florida Blue coverage rules, Florida Medicaid LTC program billing, and the coding trends that drive denials in Florida's high-volume senior care market.
Florida Medicaid managed through AHCA uses managed care plans as the primary delivery system. RCMAXIS submits and tracks claims across Molina Healthcare, WellCare Health Plans, Simply Healthcare, and Sunshine Health — ensuring prior auths, EVV compliance, and managed care billing rules are followed on every claim.
Florida leads the nation in Medicare Advantage penetration. RCMAXIS billing teams are trained on MA-specific prior auth requirements, step therapy rules, and the coverage determination processes that differ between traditional Medicare and each MA plan — preventing the denials that catch Florida providers off guard.
Florida provider credentialing involves AHCA enrollment, Medicare Part B, and all major commercial and MA payers. RCMAXIS manages the full credentialing lifecycle — primary source verification, CAQH maintenance, payer applications, and re-credentialing — targeting 60-day enrollment completion.
Florida MA denial rates are among the highest in the country. RCMAXIS denial management team investigates every denied claim, corrects root causes, and submits appeals with supporting clinical documentation — reducing write-offs and recovering revenue that practices typically lose to administrative abandonment.
Reduce overhead while maintaining billing performance with RCMAXIS's dedicated virtual assistant services. Florida practices get trained billing support staff handling eligibility verification, prior auth submission, appointment scheduling, and AR follow-up — at a fraction of in-house hiring cost.
Florida Medicare Part B providers subject to MIPS face payment adjustments that can swing up to 18 percentage points. RCMAXIS manages MIPS measure selection, data collection, and CMS submission — maximizing your composite score and protecting your Medicare payment rates.
RCMAXIS serves Florida providers statewide — our fully remote billing model means expert billing support is available to any Florida practice, regardless of location.
Miami-Dade, Broward, Palm Beach counties
Greater Orlando, Kissimmee, Sanford, Brevard
Tampa, St. Petersburg, Clearwater, Sarasota
Jacksonville, St. Augustine, Duval County
Broward County, Hollywood, Pompano Beach
Southwest Florida, Lee and Collier counties
North Florida, academic and government markets
Rural Florida, FQHCs, RHCs, Critical Access