
Get the free Florida Health Plans Direct Referral Authorization Form 11-5-13
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DIRECT REFERRAL No authorization number is required for payment. Send a copy of this form with billing to: Claims Department, Positive Healthcare, P.O. Box 7490, La Verne, CA 91756 Patient Name: DOB:
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Florida Health Plans Direct is an online marketplace where individuals and families can compare and purchase health insurance plans.
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Information such as personal details, medical history, and coverage preferences must be reported on Florida Health Plans Direct.
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