Florida Blue Appeal Form. Please submit only one claim adjustment, status check or appeal per page and mail with appropriate attachments to blue cross. Please complete the form in its entirety.
However, where appropriate, the content may identify a particular company; Florida blue provider disputes department. The appeal must relate to the bcbsf or health options, inc.
There, any pronouns refer to that specific entity.
Select providers, then provider manual. The appeal must relate to the florida blue or florida blue hmo (health options, inc.) application of coding, payment rules and methodologies for professional service claims (including without limitation any bundling, If you are not satisfied with the result of your complaint or appeal, you can request an independent review. While not required, this form may make submitting your redeterminations easier.