Get the free FHCP PRECERTIFICATION FORM - Florida Health Care Plans

FLORIDA HEALTH CARE PLANS P.O. BOX 9910 DAYTONA BEACH, FL 32120 AUTH #: CENTRALS REFERRALS DEPARTMENT FAX 386-238-3253 PHONE 386-238-3215 / 1-800-729-8349 RECERTIFICATION FORM **REQUEST FOR RECERTIFICATION

How to fill out fhcp precertification form

1. To fill out the FHCP precertification form, you will need the following information:
2. Start by downloading or obtaining a copy of the FHCP precertification form. This form is usually available on the FHCP website or can be requested from your healthcare provider's office.
3. Fill in the member information section of the form accurately. Make sure to provide all required details, including your full name, member ID, date of birth, address, and contact information.
4. On the form, locate the section for healthcare provider information. Enter the name, address, phone number, and fax number of the provider who is requesting the precertification.
5. Describe the service or treatment that requires precertification in detail. Include any relevant information such as the reason for the treatment, the expected duration, and any supporting documentation.
6. If applicable, enter the appropriate CPT codes for the service or treatment being requested. These codes help the insurance company understand the specific procedure being performed.
7. Gather any supporting documentation that may be required for the precertification process. This could include medical records, test results, or notes from the healthcare provider. Attach these documents to the precertification form or submit them separately based on the instructions provided.
8. Review the completed form to ensure all information is accurate and complete. Double-check that you have attached any necessary supporting documents.
9. Finally, submit the filled-out precertification form along with the supporting documents to the designated FHCP department or address, as instructed. It is advisable to keep a copy of the form and documentation for your records.

Who needs FHCP precertification form:

1. The FHCP precertification form is typically required by individuals who are covered under an FHCP insurance plan and need to obtain approval from the insurance company for specific medical services or treatments.
2. Healthcare providers, such as doctors, specialists, or hospitals, also require the FHCP precertification form to request approval from the insurance company on behalf of the patient. This ensures that the services or treatments provided will be covered under the insurance plan.
3. It is important to note that the need for precertification may vary based on the insurance plan and the specific medical service or treatment. It is always recommended to check with your insurance provider or refer to the insurance policy documents to determine whether the precertification form is required for your particular case.

For pdfFiller’s FAQs

What is fhcp precertification form?

The fhcp precertification form is a form that must be submitted to Florida Health Care Plans (FHCP) for approval before receiving certain medical services.

Who is required to file fhcp precertification form?

Members who are covered by FHCP insurance and are seeking approval for certain medical services are required to file the precertification form.

How to fill out fhcp precertification form?

The precertification form can be filled out online through the FHCP website or by contacting FHCP customer service for assistance.

What is the purpose of fhcp precertification form?

The purpose of the precertification form is to ensure that medical services meet FHCP's guidelines for coverage and approval.

What information must be reported on fhcp precertification form?

The precertification form requires details about the medical service being requested, the healthcare provider, and the medical necessity of the service.

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