Contact Us: Florida Blue Quick Reference Guide

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Contact Name	Contact For	Phone / Email / Website
BlueCard^® Eligibility	Out-of-Area Member Benefit and Utilization Management Questions	800-676-BLUE (2583) Website: Availilty®
Care Management/Disease Management	Members with an active health plan policy are eligible for referral into our Care Management Programs. Any Acute or Chronic Condition, or Event that would benefit from engagement with a Registered Nurse; is an appropriate referral. We focus in and target the top 5 Chronic Conditions, High Cost, High Risk, and select Specialty diagnoses for outreach calls. Complex Case Management/Transplant Oncology Case Management Neonatal Intensive Care Unit (NICU) High-Risk Maternity Program Chronic Condition Management Medicare Advantage Care Programs	Care Management Phone: 844-730-BLUE (2583) Email: carememberoutreach@bcbsfl.com Medicare Advantage Phone: 800-955-5692 Email: medicare_casemanagement_vm@bcbsfl.com Transplant Requests Phone: 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 South Counties include: Miami-Dade, Monroe, Broward, Palm Beach, Martin, St. Lucie, Okeechobee, Indian, Collier, Lee, Charlotte, Glades, Hendry, Hardee, Desoto, Manatee, Highlands, Sarasota, Pinellas, Hillsborough, Hernando, Pasco *North Counties include: Nassau, Duval, St. John, Clay, Putnam, Baker, Union, Bradford, Alachua, Marion, Columbia, Gilchrist, Levy, Citrus, Hamilton, Suwannee, Dixie, Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, Bay, Jackson, Calhoun, Gulf, Gadsden, Liberty, Franklin, Leon, Wakulla, Jefferson, Taylor, Madison, Lafayette, Orange, Osceola, Polk, Flagler, Volusia, Lake, Sumter, Brevard, Seminole	Preservice Medical Review Phone: 800-955-5692 (Use Availity®1 to enter your authorizations, referrals, and inquiries) Transplant Requests Phone: 844-701-2583 Peer to Peer Phone: 800-955-5692 General/VPCR/VPSS Fax: 877-219-9448 Prescription Fax: 904-905-9849 Transplant Fax: 904-357-6331 Medicare Advantage, Florida Blue Medicare℠, Medicare PPO Medical Fax: 904-301-1614 Medicare Advantage, Florida Blue Medicare Part B Rx Fax: 904-357-6699 FEP Preservice/VPCR Request Fax: 866-441-1569 FEP Preservice/VPCR Request Fax: 866-441-1569 State Account Preservice/VPCR Request Fax: 866-441-1568 Concurrent Review Fax numbers: Med Advantage: 954-714-4109 Statewide Discharge Census: 888-757-4921 Federal & State Employees: 850-479-6686 Commercial South* Region: 813-806-1428 Subacute Care South* Region: 954-714-4143 Commercial North Region (includes FL Travelers): 407-804-4432 Subacute Care North Region (includes FL Travelers): 305-716-2731 Subacute Care Med Advantage: 813-806-1277 Out of State Residents: 904-357-6087 Note: 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 Contract Inquiries (Provider Contracting, Provider Practice Changes) Availity Issues Dental Inquiries	Customer Service Phone: 800-727-2227 (then say one of the choices) Fee Schedule Request Form Website: floridablue.com/providers/forms
Federal Employee Program^® (FEP)	Lucet Prior Approval Care Coordination / Case Management Prior Authorization	Lucet Phone: 1-866-350-2280 Email: BCBSFICMReferrals@ndbh.com Care and Case Management Phone: 1-866-287-9569 Prior Authorization Phone: 800-955-5692
Dental	Customer Service: Claims and Eligibility/Benefits Contract and Fee Schedule Inquiries Fee Schedule Requests	Customer Service Phone: 888-223-4892 Website: FloridaBlueDental Contract and Fee Schedule Inquiries Email: dentalproviderrelations@fclife.com Website: floridabluedental.com/providers/tools-and-resources/fee-schedules/
Fraud / Abuse	Reporting Fraud and Abuse	Phone: 800-678-8355 Email: specinvestunit@bcbsfl.com
Healthy Addition	Prenatal Program	Phone: 800-955-7635, Option 6 Email: healthyaddition@bcbsfl.com
IRS Form 1099	Questions Regarding Form 1099	Email: 1099admin@bcbsfl.com
Revenue Program Management	Medicare / Commercial Risk Adjustment Education Comprehensive Quality and Risk Program (CQRP) Provider Reimbursement Payment Programs	Commercial Email: craprovidereducationteam@bcbsfl.com Medicare Email: riskadjustmenttraining@bcbsfl.com
State Employees	State Employee Group Inquiries	Phone: 800-825-2583 Website: floridablue.com/state-employees

Florida Blue Vendor Quick Reference Guide

Contact Name	Contact For	Phone / Email / Website
Alignment Health	BlueMedicare^SM Preferred HMO in Clay, Duval, Sarasota, Pinellas and Manatee Counties	Phone: 844-783-5191
American Specialty Health	Chiropractic Services and Massage Therapy (performed by chiropractor) for claims processing, utilization management services and benefits	Phone: 800-972-4226 Website: ashlink.com
Availity	Non-Emergent Cardiology Services	Phone: 800-AVAILITY / 800-826-4548 Website: availity.com
Availity¹	Technical Support / Self-Service Tools	Phone: 800-AVAILITY / 800-282-4548 Email: support@availity.com
Blue Canadian Travel Insurance	Customer Service Pre-approval of Medical Services	Customer Service Phone: 800-727-2227 Pre-approval Phone: 833-929-0903 Email: operations@canassistance.com
Blue TPA Canadian Travel Insurance	Customer Service Pre-approval of Medical Services	Customer Service Phone: 800-995-1683 Pre-approval Phone: 800-361-6068 Email: Florida.Providers@canassistance.com
CareCentrix^®	Durable Medical Equipment (DME) Home Health Home Infusion Coordination Orthotics and Prosthetics	Phone: 8 77-561-9910 Fax: 877-627-6688 Website: carecentrixportal.com
CareCentrix Sleep Management	Sleep Management Program	Phone: 8 55-243-3326 Fax: 855-243-3344 Website: sleepsms.com
Caremark Specialty Pharmacy Services	Specialty Pharmacy Program Hemophilia Program Stock Replacement Program	Phone: (866) 814-5506, Options 1 and 4 Fax: (866) 249-6155 FEP Plan Phone: (877) 727-3784
Council for Affordable Quality Healthcare (CAQH)	Credentialing Technical Support Fax Supporting Documentation	Phone: 888-599-1771 Fax: 866-293-0414 Email: Caqh.updhelp@acsgs.com Webpage: upd.caqh.org/oas
CoverMyMeds^®	Retail Pharmacy / Part D Electronic Prior Authorizations	Phone: 866-452-5017 Webpage: covermymeds.com/main/partners/floridablue
Dermatology Network Solutions (DNS) / Podiatry Network Solutions (PNS)	Dermatology Network (South Florida) Podiatry Network (South Florida)	Dermatology Network Phone: 844-222-3535 Podiatry Network Phone: 844-222-3939 Dermatology and Podiatry Email: info@pns-mgmt.com
eDispense (EDVM)	Vaccine Manager	Phone: 866-522-3386 Webpage:www.transactrx.com
Eye Management, Inc. (EMI)	Ophthalmology Services (South Florida)	Phone: 800-329-1152 Fax: 305-620-5873
Health Dialog	Care Navigation Capability	Phone: 877-789-2583
Implantable Provider Group (IPG)	Implantable Device Procurement Program	Phone Toll Free: (866) 753-0046 Phone: (770) 753-0046 Fax: (866) 753-0194 Email: info@ipg.com Webpage: www.ipg.com
Prime Therapeutics Management	Physician Administered Drug Program (PADP)	Phone: 800-424-4947, Option1 Fax: 888-656-6671 Website: https://gatewaypa.com/
MES Solutions	Adverse Determination Disputes Billing Dispute External Review	Phone: 800-437-8583 Fax: 888-868-2087 Email: info@messolutions.com Website: mesgroup.com
My Home Doctor	PATCH Program (South Florida)	Phone: 888-696-4322 Email: customerservice@myhomedoctor.com
Lucet	Psychiatric or substance abuse needs	Phone : (866) 730-5006
Prime Specialty / Alliance RX	Provider Administered	Phone: (866) 260-0452 Fax: (877) 239-9285

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.

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