Health and Human Services

Welcome to Health Plan and Eligibility & Utilization Services

The Tribal Health Plan is responsible for providing quality Medical and Dental Health care providers to the Tribal Community while assuring cost-effectiveness and excellent customer service. This program functions under the leadership of the Health & Human Services department and addresses healthcare challenges while ensuring the best customer service experience whether in claim payment, claims appeals, pre-certifications, contract negotiations, coordination of benefits with plans or networks and eligibility. Quality patient care and payments are at the forefront. There are 7 staff members employed within the Health Plan. We welcome you to explore this site to find information on each staff member along with other contact information to assure a great health care experience.

The Eligibility & Utilization Services Program is where access to health services begins. This program provides many services to patients including:

• Registration for the Seminole Tribe of Florida Self-Funded Health Plan – Tribal Members Only
• Registration for Health Services for other individuals eligible for direct health care and purchased/referred care in accordance with 42 CFR Part 136 and other Seminole Tribe of Florida guidelines
• Generate referrals and schedule appointments for patients requiring services outside of the Seminole Tribe of Florida Health Clinic
• Provide education and assistance to patients concerning eligibility, registration for health services, and benefits
• Distribute Seminole Tribe of Florida Self-Funded Health Plan cards and Plan books 
• Ensure HIPAA compliance
• Assist patients with matters related to HIPAA and privacy complaints
• Manage the Medicare Premium payment/reimbursement program
• Audit global invoices and check runs

The Health Plan is conveniently located at the below address:

Seminole Tribe of Florida Health Plan Administration

111 West Coral Way, Room 107

Hollywood, FL 33021

Health plan toll free number: 866-505-6789

Hours of operation: Monday through Friday 8:00am to 5:00pm

All SEMINOLE TRIBE OF FLORIDA HEALTH CLINICS are available for care at the below locations: