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  • Pre-certification Request Form - Freedom Health

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PRE-CERTIFICATION REQUEST FORM All REQUIRE MEDICAL RECORDS TO BE ATTACHED Phone: (888) 796-0947 Fax: (888) 736-1123 or (813) 506-6226 Instructions: This form is for pre-certification requests which.

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Freedom Health, Inc. has been awarded an overall rating of 4.5 Stars based on Centers for Medicare and Medicaid Services' (CMS) Star Rating methodology, which is a measure of overall health plan performance.

Claims must be submitted within 12 months of the date of service.

You, your representative or health care provider acting on your behalf can file a grievance concerning an adverse decision within 180 days after you receive the initial benefit decision.

Freedom Health and Optimum HealthCare are part of an Elevance Health company that offers a broad portfolio of affordable and benefit-rich Medicare Advantage plans throughout Florida.

Claims must be submitted to Freedom Health within 90 days of date of denial from EOB.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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