Services

What We Provide

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:


Hollywood Health Clinic
111 West Coral Way, Room 107
Hollywood, FL  33021
Medical:  (954) 962-2009
Dental:  (954) 964-3411
Center for Behavioral Health:  (954) 964-6338​
Big Cypress Health Clinic
31055 Josie Billie Hwy.
Clewiston, FL  33440
Medical:  (863) 983-5151
Dental:  (863) 983-5151
Center for Behavioral Health:  (863) 902-3206​

Brighton Health Clinic
17201 Civic Street
Okeechobee, FL  34974
Medical:  (863) 763-0271
Dental:  (863) 763-0271
Center for Behavioral Health:  (863) 763-7700​
Immokalee Health Clinic
1120 South 1st Street
Immokalee, FL  34142
Medical:  (239) 867-3400
Dental:  (239) 867-3410
Center for Behavioral Health:  (239) 867-3480​

Tampa Health Clinic
6401 Harney Rd.
Tampa, FL 33610
Medical:  (813) 620-2860
 Center for Behavioral Health:  (813) 246-3100​
Children's Center for Diagnostics & Therapy
6365 Taft St., # 1003
Hollywood, FL  33024
(954) 985-2320​

Seminole Pharmacy
6401 Sheridan Street
Hollywood, FL 33024
(954) 965-1331 or (866) 961-7210​
BMJ Pharmacy
111 West Coral Way, Room 107
Hollywood, FL 33021

Angela LambertAngela Lambert

Director of Health Plan and Eligibility & Utilization

954-981-7410 Ext: 10206

 


Cindy Cozier
Senior Claims Auditor of Health Plan Administration
954-981-7410 Ext. 10207

Sonji Beacham
Clerical Assistant of Health Plan Administration
954-981-7410 Ext. 10200

Sonia King
Claims Analyst of Health Plan Administration
954-981-7410 Ext. 10232

Karen Aguayo
Provider Relations Representative
954-981-7410 Ext. 10208

Yvette Jones
Claims Auditor of Health Plan Administration
954-981-7410 Ext. 10210​

Magalie Pena
Health Plan Manager
954-981-7410 Ext. 10219

Latisha Welsh
Claims Auditor
954-981-7410 Ext. 10347

Latisha Welsh
Claims Auditor
954-981-7410 Ext. 10347

Abbigail Mezil - Eligibility & Utilization Coordinator


Ulecia Green - Eligibility & Utilization Services Supervisor 


Lisa Borges - Patient Services Coordinator – Betty Mae Jumper Health Clinic


Angelia Diaz - Patient Services Coordinator – Big Cypress Health Clinic​


Candice Diehl - Patient Services Coordinator – Brighton Health Clinic


Rosalinda Silva - Patient Services Coordinator – Immokalee Health Clinic​​​​​​


Contact Health Plan

 

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