News: Online Automated Appeal Forms
with Real Time Decisions
Florida Blue will soon offer online provider appeal forms that deliver automated decisions in real time. The goal is to reduce costs for both providers and Florida Blue to make health care more affordable. To submit an appeal, providers… more
News: Updates to Clinical Forms to
Add Multiple Codes Submission
Beginning in July, 2016 Florida Blue will release improvements to certain Clinical Forms. These updates will allow providers to submit for multiple lines within a single form or submit multiple forms related to multiple services for a single request. This will… more
Florida Blue Medical Policies
There are multiple methods for browsing within the Medical Policies (Medical Coverage Guidelines).
To open a specific category on the left-hand side, click the folder icon to expand the contents. You can click on the title to view the guideline. You may collapse the categories by clicking Contents in the navigation bar at the top or display all guidelines in alphabetical order by clicking Index.
You may also search for information by typing a keyword or phrase in the Search box in the upper right-hand corner and click Search.
For more information on using the MCGs, click on the Help button in the blue banner.
New information for each guideline will be shown in Red.
New information or technology that would be relevant for Florida Blue to consider when a policy is next reviewed may be submitted to:
Medical Policy Area
4800 Deerwood Campus Parkway
Building 900, 4th floor
Jacksonville, FL 32246-8273
Preventive services include a broad range of services (including screening tests, counseling, and immunizations/vaccines). We have adopted the U.S. Preventive Services Task Force (USPSTF) Guide to Clinical Preventive Services [childhood and adolescent immunization schedule approved by: the Advisory Committee on Immunization Practices (ACIP), the American Academy of Pediatrics (AAP), and the American Academy of Family Physicians (AAFP); adult immunization schedule approved by: the Advisory Committee on Immunization Practices (ACIP), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Family Physicians (AAFP)].
Centers for Disease Control and Prevention (CDC) (recommended vaccines and immunizations).
Guide to Clinical Preventive Services (recommendations made by the USPSTF for clinical preventive services).