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Skip to Footer Language English Español Contrast Accessibility Normal Style Low Contrast High contrast Animation Control Turn off all animations Contact & Help Contact Us Español FloridaBlue.com For Employers For Agents For Providers Find a Florida Blue Center Your Center: Jacksonville Jacksonville Center 14 miles away 4855 Town Center Pkwy Jacksonville, FL 32246-8437 (904) 363-5870 Find A Different Center Log in Login News Programs Tools & Resources Forms Ethics & Compliance Search Enter your search criteria: Search within: Entire Site Agents Employers Members Providers Search Quick Search Member Forms Make a Payment Rewards Programs Login Find a Florida Blue Center Your Center: Jacksonville Search Site Settings Shop Plans Find a Doctor Member ResourcesMedicare For Employers For Agents For Providers Contact Us Shop Medicare Plans Shop Individual & Family Plans Shop Business Plans Find a Doctor or Dentist Virtual Care Medicare Plans Individual & Family Plans Employee Plans Quick Links Medicare Member Resources Medicare Forms HealthyBlue Rewards Health & Wellness Programs Learn About Medicare Individual & Family Plan Member Resources Individual & Family Plan Forms How Health Coverage Works BlueAnswers Better You Strides Rewards My Rewards Center Employee Plan Member Resources Group Plan Administrator Resources Employee Plan Forms Better You Strides Rewards BlueAnswers Account Login Register for My Account Manage My Account Find Care & Compare Medical Costs Pay My Bill My Claims View My ID Card Florida Blue App Our Story Our Health Solutions Championing Florida’s Health Home Learn About Medicare Find A Plan Member Resources Contact Us Learn About Medicare What is Medicare? Types Of Plans Eligibility & Enrollment Picking The Right Plan Turning 65? Help For Caregivers Find A Plan Shop Plans Part C: Medicare Advantage Part C: Special Needs (D-SNP) Part D: Prescription Drug Medicare Supplement (Medigap) Why Choose Blue? Quick Links Member Resources Account Log-In Health & Wellness HealthyBlue Rewards Care Programs Contact Us Quick Links Find a Doctor Find a Pharmacy Find a Form Find a Center Find an Event Home Shop Plans Resources Login Shop Plans For Small Businesses For Mid-Sized Businesses For Large Businesses Comprehensive Benefits Resources Group Administrator Guides Gateway e-Learning Platform Guide to Automated Enrollment Medicare Information Home Resources Become an Agent Sales Offices Resources Access Agent Point Group Administrator Guides Medicare Forms & Documents Dental Agent Guides Home Tools & Resources Forms News Language English Español Contrast Accessibility Normal Style Low Contrast High contrast Animation Control Turn off all animations Contact & Help Contact Us Jacksonville Center 14 miles away 4855 Town Center Pkwy Jacksonville, FL 32246-8437 (904) 363-5870 Find A Different Center Search Enter your search criteria: Search within: Entire Site Agents Employers Members Providers Search Quick Search Member Forms Make a Payment Rewards Programs Manual for Physicians and Providers Overview News Bluemail Bulletins & FAQs Forms Availity Log-in Availity Online Services Provider Manual Programs Advance Care Planning CMS Member Survey Experience Federal Employee Program Kidney Health Management Quality: HEDIS & PQA Measures Quality: Medicare Stars Quality: Readmissions Review Risk Adjustment Utilization Management Value-Based Alternative Payment Medical & Pharmacy Policies Dental Information Medical Policies (Medical Coverage Guidelines) Medication Guide Medical Policy, Pre-Certification, Pre-Authorization Part B Step Therapy Payment Policies Pharmacy Utilization Management Practice & Preventive Service Guidelines Prior Authorization Specialty Pharmacy Billing Companion Documents Online Training Behavioral Health Behavioral Health Ecosystem Measurement-Based Care in Behavioral Health Psychotherapeutic Medication Guidelines Virtual Treatment Advocacy Resources Pain Management Chronic Pain Management Opioid Addiction & Overdose Medication Temporary Insurance More topics: Overview ────────── News Bluemail Bulletins & FAQs ────────── Forms Availity Log-in Availity Online Services Provider Manual ────────── Programs Advance Care Planning CMS Member Survey Experience Federal Employee Program Kidney Health Management Quality: HEDIS & PQA Measures Quality: Medicare Stars Quality: Readmissions Review Risk Adjustment Utilization Management Value-Based Alternative Payment ────────── ────────── Medical & Pharmacy Policies Dental Information Medical Policies (Medical Coverage Guidelines) Medication Guide Medical Policy, Pre-Certification, Pre-Authorization Part B Step Therapy Payment Policies Pharmacy Utilization Management Practice & Preventive Service Guidelines Prior Authorization Specialty Pharmacy ────────── Billing Companion Documents Online Training ────────── Behavioral Health Behavioral Health Ecosystem Measurement-Based Care in Behavioral Health Psychotherapeutic Medication Guidelines Virtual Treatment Advocacy Resources ────────── ────────── Pain Management Chronic Pain Management Opioid Addiction & Overdose Medication ────────── Temporary Insurance The Manual is not intended to be a complete statement of all Florida Blue polices or procedures for providers. Other policies and procedures, not included in this manual, may be posted on our website or published in special publications, including but not limited to, letters, bulletins, or newsletters. Any section of this Manual may be updated at any time. Florida Blue may notify providers of updates in a variety of ways, depending upon the nature of the update, including mailings, Bluemail communication, or posting to our website at www.floridablue.com. Provider Manual File Name Format Provider Participation, Plans and Products, Utilization Management, Standing Authorizations PDF Claim Submission, Billing Guidelines PDF Care Review, Coordination of Benefits, Appeals and Grievances, Quality and Compliance Programs, Self-Service Tools and Resources PDF Common Fee Schedule by Provider Type Ancillary File Name Format Acupuncture PDF Ambulance PDF Ambulatory Infusion Center PDF Birthing Center PDF Durable Medical Equipment PDF Hearing Aid Dealer PDF Independent Clinical Laboratory PDF Independent Diagnostic Testing Center PDF Rehabilitative Therapy PDF Sleep Center PDF Urgent Care Center and Immunizations PDF Facility File Name Format Ambulatory Surgical Center PDF Prior Authorization Lists and Utilization Management File Name Format Provider Administered Drug Program PDF Medical Pharmacy PA/UM Drug List PDF Let us know how we can help. 800-352-2583 Quick Links Find a Center Find an Agent Find a Doctor For Developers Pharmacy Helpful FAQs About Florida BlueFlorida Blue Foundation Careers Newsroom Blog Health coverage is offered by Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. HMO coverage is offered by Health Options, Inc. DBA Florida Blue HMO. Dental, Life and Disability are offered by Florida Combined Life Insurance Company, Inc., DBA Florida Combined Life. These companies are Independent Licensees of the Blue Cross and Blue Shield Association. Español , Kreyòl Ayisyen , Tiếng Việt , Português , 中文 , Français , Tagalog , Русский , العربية , Italiano , Deutsch , 한국어 , Polski , ગુજરાતી , ไทย , 日本語 , فارسی , 繁體中文 © 2024 Blue Cross and Blue Shield of Florida, Inc. DBA Florida Blue. All rights reserved. FBC MEGA NF 012024 Internet Privacy Statement Nondiscrimination and Accessibility Notice Terms of...