Contact Us: Florida Blue Quick Reference Guide

Contact Name Contact For Phone / Email / Website
BlueCard® Eligibility
  • Out-of-Area Member Benefit and Utilization Management Questions
800-676-BLUE (2583)
Care Management/Disease Management
  • Complex Case Management/Transplant
  • Oncology Case Management
  • Neonatal Intensive Care Unit (NICU)
  • High-Risk Maternity Program
  • Chronic Condition Management
  • Medicare Advantage Care Programs
844-730-BLUE (2583)

carememberoutreach@bcbsfl.com

Medicare Advantage: 800-955-5692

medicare_casemanagement_vm@bcbsfl.com

Transplant Requests: 844-701-2583

Fax: 904-357-6331
Utilization Management
  • Preservice Medical Review - Prior Authorizations and Referrals
  • Concurrent Review - Inpatient Acute or Sub-Acute Admissions
  • Peer to Peer Review – Only for Florida Blue Denied Authorizations

Preservice Medical Review Department: 800-352-2583 (Use Availity®1 to enter your authorizations, referrals and inquiries)

Transplant Requests: 844-701-2583

Fax Numbers: (include your authorization number on the medical records being faxed)
Contact Center

*Availity Transaction ID or Provider NPI required
  • Claims Payment
  • Eligibility and Benefits
  • Authorizations and Referrals
  • Provider Number
  • Contract Inquiries (Provider Contracting, Provider Practice Changes)
  • Availity Issues
  • Dental Inquiries
800-727-2227 then say one of the choices

Fee Schedule Requests Form:
floridablue.com/providers/forms
Federal Employee Program® (FEP)
  • New Directions Behavioral Health Prior Approval
  • Care Coordination / Case Management
  • Mail Service Member Customer Service
  • Prior Authorization
Dental
  • Customer Service: Claims and Eligibility/Benefits
  • Contract Inquiries via Email
  • Fee Schedule Requests via Email
Fraud / Abuse Reporting Fraud and Abuse 800-678-8355
specinvestunit@bcbsfl.com
Healthy Addition Prenatal Program 800-955-7635, Option 6
healthyaddition@bcbsfl.com
IRS Form 1099 Questions Regarding Form 1099 Fax: 913-982-8401
1099admin@bcbsfl.com
Revenue Program Management
  • Medicare / Commercial Risk Adjustment Education
  • Comprehensive Quality and Risk Program (CQRP)
  • Provider Reimbursement Payment Programs
riskadjusmenttraining@bcbsfl.com
State Employees State Employee Group Inquiries 800-825-2583

Florida Blue Vendor Quick Reference Guide

Contact Name Contact For Phone / Email / Website
Advanced Imaging Management Non-Emergent Cardiology Services 844-423-0879 / Clinical Guidelines:
aimprovider.com/cardiology
Alignment Health BlueMedicareSM Preferred HMO in Clay, Duval, Sarasota, Pinellas and Manatee Counties 844-783-5191
American Specialty Health Chiropractic Services and Massage Therapy (performed by chiropractor) for claims processing, utilization management services and benefits 800-972-4226
ashlink.com
Availity1 Technical Support / Self-Service Tools 800-AVAILITY / 800-282-4548
support@availity.com
Canadian Travel Insurance
  • Customer Service
  • Pre-approval of Medical Services
800-995-1683
Atlantic/Ontario 800-562-4444
Quebec 800-361-6068
floridaproviders@canassistance.com
CareCentrix®
  • Durable Medical Equipment (DME)
  • Home Health
  • Home Infusion Coordination
  • Orthotics and Prosthetics
877-561-9910 Fax: 877-627-6688
carecentrixportal.com
CareCentrix Sleep Management Sleep Management Program 855-243-3326
sleepsms.com
Caremark Specialty Pharmacy Services
  • Specialty Pharmacy Program
  • Hemophilia Program
  • Stock Replacement Program
866-278-5108, Fax: 800-323-2445
Council for Affordable Quality Healthcare (CAQH)
  • Credentialing Technical Support
  • Fax Supporting Documentation
888-599-1771, Fax: 866-293-0414
Caqh.updhelp@acsgs.com
upd.caqh.org/oas
CoverMyMeds® Retail Pharmacy / Part D Electronic Prior Authorizations 866-452-5017 covermymeds.com/main/partners/floridablue
Dermatology Network Solutions (DNS) / Podiatry Network Solutions (PNS)
  • Dermatology Network (South Florida)
  • Podiatry Network (South Florida)
888-959-8714
info@pns-mgmt.com
eDispense (EDVM) Vaccine Manager 866-522-3386
transactrx.com
Eye Management, Inc. (EMI) Ophthalmology Services (South Florida) 800-329-1152
Health Dialog Care Navigation Capability 877-789-2583
Implantable Provider Group (IPG) Implantable Device Procurement Program 866-295-3195, Fax: 866-295-4773
ipgsurgical.com
Magellan Rx ManagementSM Physician Administered Drug Program (PADP) 800-424-4947
ih.magellanrx.com
MES Solutions
  • Adverse Determination Disputes
  • Billing Dispute External Review
800-437-8583, Fax: 888-868-2087
mesgroup.com
My Home Doctor PATCH Program (South Florida) 888-696-4322, Email questions to:
customerservice@myhomedoctor.com

1 Availity, LLC is a multi-payer joint venture company. For more information or to register, visit availity.com. Florida Blue is an independent licensee of the Blue Cross and Blue Shield Association.