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EXTERNAL REVIEW REQUEST Return to: Florida Blue Attention: Appeals and Disputes PO Box 44197 Jacksonville, FL 32231-4197 This External Review Form must be filed with Florida Blue s Member Appeals
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How to fill out Florida Blue external reviews:

01
Visit the Florida Blue website and log in to your account.
02
Navigate to the "Claims & Accounts" section and select "File a Claim."
03
Choose the option for "External Review" and provide the necessary details, such as your name, policy number, and contact information.
04
Clearly explain the reason for the external review and provide any supporting documentation.
05
Submit the form and wait for a confirmation email or letter from Florida Blue acknowledging receipt of your request.

Who needs Florida Blue external reviews?

01
Individuals who have received a denial or adverse determination from Florida Blue.
02
Policyholders who disagree with a decision made by Florida Blue regarding their coverage or claims.
03
Anyone who believes they have been wrongly denied benefits or services by Florida Blue and wishes to have an independent review of their case.
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Florida Blue external reviews are evaluations conducted by external entities to assess the performance, processes, and compliance of Florida Blue, a health insurance company, with relevant regulations and standards.
Florida Blue, as a health insurance company, is required to file external reviews to demonstrate its compliance with regulations and standards set by governing authorities.
To fill out Florida Blue external reviews, the company needs to follow the guidelines provided by the external entity conducting the review. This may include providing relevant documentation, answering questionnaires, and participating in on-site visits or interviews.
The purpose of Florida Blue external reviews is to ensure that the company operates in accordance with regulations and standards, maintains high-quality services, and meets the needs of its customers and stakeholders.
The specific information that must be reported on Florida Blue external reviews will depend on the requirements set by the external entity conducting the review. It may include financial data, performance metrics, compliance documentation, and customer feedback.
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