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Date Printed: July 21, 2017: 12:27 AM

Florida Blue Provider News

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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.

How the Appeal Forms Work

To submit an appeal, providers will access an online form for the
appealed service in the PASSPORT Portal. The form asks the provider a
series of questions. Once completed, PASSPORT sends the form to
Florida Blue’s care management system for processing. After the form
is processed, the provider receives a real time decision for that appeal online.

Accessing the Forms

Providers can access PASSPORT through Availity at www.availity.com.
On the left navigation bar, select My Payer Portals, and then Florida
Blue PASSPORT Portal
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Clinical Forms to offer Submitting
Multiple Lines per Form and Multiple Forms

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 further simplify and accelerate the
review process to improve provider office efficiency.

Until recently, the fastest way to complete a medical review for certain
claims was to use a Florida Blue Certificate of Medical Necessity (CMN).
In these printable forms, providers answer a series of questions from a
member’s medical documentation, attest to the information’s
authenticity, and then send the form to Florida Blue for review.

In 2015, Florida Blue also offered Clinical Forms, online versions of
CMNs, for certain procedures. These deliver medical documentation
much faster, eliminating the need to fax, mail, or email information to
Florida Blue. Once submitted, in most cases, providers can receive
real-time, automated referral and authorization decisions.

Accessing the Forms

Providers can access Clinical Forms in Availity at www.availity.com.

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Date Printed: July 21, 2017: 12:27 AM