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  • Blue Cross Blue Shield Prior Authorization Form Florida

Get Blue Cross Blue Shield Prior Authorization Form Florida

/ PRIOR AUTHORIZATION REQUEST FORM An Independent Licensee of the Blue Cross and Blue Shield Association. This form is for authorization of prescription drug benefits only and must be COMPLETELY filled.

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Contact support

Contact us by email at rpmchartprocurement@floridablue.com, by fax at 904-301-1557 or toll free call at 1-855-622- 2735. Be sure to include your name, contact information and provider group.

Your doctor must contact Florida Blue at 1-877-719-2583 or its delegate at (800) 424-4947 at MagellanRx Management. You can also check the status of your authorization by contacting the phone number on the back of your ID card.

About Florida Blue Florida Blue is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. For more information, visit .FloridaBlue.com.

You are solely responsible for getting any required authorization before services are rendered, regardless of whether you go to an in- or out-of-network health care provider. An in-network health care provider will request a prior authorization on your behalf.

Florida Blue is an independent licensee of the Blue Cross Blue Shield Association, serving residents and businesses in the state of Flo. If you are a member and need help, please contact socialmediasupport@floridablue.com.

FL​ Blue Cross Blue Shield of Florida.

GuideWell, formally GuideWell Mutual Holding Corporation (holding company for Florida Blue), is a mutual insurance holding company primarily focused on health insurance in Florida.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232