Member Policies - Medical Policies - Florida
Policies & Guidelines
- Advanced Imaging
- Behavioral Health
- Chronic Condition Management
- Genetic Testing Management
- Hemophilia Drug Management
- Medical Policies
- Precertification Information
- Provider-Administered Drug Policies (Excluding Oncology)
- Provider-Administered Oncology Drug Policies
- Radiation Therapy Management (RTM)
- Self-Administered Drug Policies
- Transgender Services
Precertification Information
Online Precertification
Online precertification/pre-service review is available for these services:
- Behavioral Health
- Cancer Treatment Pathways
- Physician-Administered Drugs
Go to your local plan's provider portal to initiate Pre-Service Review (Electronic Provider Access) for these services for out-of-area members. Contact your local Blue Plan for more information on how to access this functionality in your local provider portal.
Radiology Precertification and Benefit Information
Use the forms listed at the bottom of this page for other services requiring precertification or call the appropriate toll-free number to initiate precertification for these services via telephone:
- 1-844-594-6010 - Physical/Occupational/Speech Therapy
- 1-855-288-8357 - All other services (including Peer-to-Peer Consultations):
Advanced Radiology Imaging (MRI, CT, PET)
Chiropractic
Home Health
Hospice
Inpatient Hospital
Long-Term Acute Care
Physical/Occupational/Speech Therapy
Predetermination (Medical, Surgical, DME)
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