Carecentrix florida blue provider phone number. Use a nebulizer for your child’s asthma? Sleep with an oxygen mask? Have a home If you have questions about a specific health plan that works with CareCentrix, please call a representative at one of the numbers below: Contact us to learn more about how we are Referral sources are encouraged to call with any questions related to home healthcare, home infusion therapy, or home medical equipment prior to making a referral. . If you have access, confirm that the following time CareCentrix calls the referral source with the name and phone number of selected direct care provider. Our whole-person approach proactively identifies and engages members from hospital to home, Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of Contact eviCore for authorization: Phone: 1-888-333-8641 Sleep Diagnostics Program Criteria Sleep Management Worksheets Wellcare Secure Provider Portal Contact Evolent for Learn how we reduce unnecessary and inappropriate utilization, coordinate care, and manage clinical guidelines and consultations for DME. Medical supplies and This form must be completed in its entirety for all faxed sleep diagnostic prior authorization requests. Provider News Find resources to help you maximize your experience as a participating Florida Blue provider. , the nation's leading If you are a contracted CareCentrix provider or sleep diagnostic provider, please contact your HomeBridge provider portal administrator. Our employer code is 16516. Purpose of this communication: • To notify providers that effective January 1, 2025 Florida Blue will no longer offer Medicare D-SNP plans and to notify of impacts to processes related to Positive Airway Pressure (PAP) devices are commonly used to treat obstructive sleep apnea and other related symptoms. The most recent clinical notes and current medication list (last 30 days) must also For general inquiries specific to Horizon Blue Cross Blue Shield of New Jersey, patients, network providers, or other interested parties can reach us at 1-855-243-3321 between the hours of Florida Blue Medicare Advantage Post-Acute Care Program Facility Discharge Quick Reference Guide (Please refer to the CareCentrix Florida Blue Patient Discharge Reference Guide for all BlueCard® Process Quick Reference Guide (QRG)March 2023 The purpose of this communication is to inform you that for claims with dates of service on and after December 15, 2025, CareCentrix is updating the pricing calculation for Stelara and July 20, 2022 Dear Valued Provider: As you may know, Wellcare Health Plans has contracted with CareCentrix to manage home health services for our Medicare and SNP members in CareCentrix is an independent company contracted with Florida Blue to manage durable medical equipment. Call 1-800-FLA-BLUE or the number on the back of your member ID card to speak with a representative. Health insurance is offered by Florida Blue. Contact “The Work Number” through their website here or via phone at 1-866-604-6572. 1, 2021. For Florida Blue’s Medicare Advantage members who are in your facility on the day the CareCentrix/Florida Blue arrangement is effective, request continued stay authorizations from FL BLUE DME Quick Reference Guide November 2024 Please note: This form is for informational purposes only and does not guarantee authorization for the equipment/services Search CareCentrix PayerID 11345 and find the complete info about CareCentrix Insurance Type, LOB, ENR, RTE, RTS, ERA, SEC, Customer Service Number and more BlueCard BlueCard is a program that allows Blue Cross Blue Shield patients to obtain health care nationally. Not a Florida Blue member? Call 1-877-465-1125 CareCentrix operates na onally with employees primarily located in Tampa, Florida; Har ord, Connec cut; Overland Park, Kansas; and Phoenix, Arizona. Call on CareCentrix for all your medical equipment, home health services, and infusion therapy needs. Refer to your service type to determine if the network is open. CareCentrix has raised an The provider portal is simply the best and most efficient way to work with CareCentrix. The discharge planner is encouraged to call with any questions related to home care Resources To access more information about the Horizon Supportive Care Program and Braven Health Supportive Care Program, CareCentrix and its network providers are not responsible for arranging non-life sustaining services for patients who are subject to suspension of services, and any such claims will be Please note, failure to complete all of the fields on this form may result in delay of patient care. HMO coverage is offered by Florida Florida Blue members can access a variety of forms including: medical claims, vision claims and reimbursement forms, prescription drug forms, coverage and Upon request, CareCentrix will obtain prior authorizations for BlueCard members residing in Florida for home health services when prior authorization is required, alternatively, the provider CareCentrix will contact you shortly to provide information and training regarding the post-acute program and new authorization so you are well informed by Oct. When you’re a Blue Cross and Blue Shield of Florida BlueOptions or BlueChoice member, you take your health care benefits with you across the country and around the world. Carecentrix can be contacted via phone at (813) 901-2150 for pricing, hours These NOMNC requirements apply to the following CareCentrix health plan customers with Medicare Advantage and/or D-SNP members: Florida Blue, Horizon/Braven, Excellus, Health coverage is offered by Blue Cross and Blue Shield of Florida, Inc. If the Patient Information on the SRF varies from what is on their ID card, refer to page Electronic claims submission is the most efficient, accurate, and reliable way to submit claims to CareCentrix. The benefits of the portal include: CareCentrix, America's leading manager of ancillary care benefits, is dedicated to its homecare provider partnerships. It operates as a Provider of home health care services. Register with or log into Availity here. Dental, Life and Disability In a recent CareCentrix study, 85% of healthcare organizations have already increased or are looking at ways to increase more care in the home, with the For Instructions on Editing a Request in HomeBridge please review the HomeBridge Portal User Guide. If you currently use these services or supplies, If the pa ent is unwilling to obtain their out-of-pocket es mate using the methods above and provider must supply the pa ent with an es mate, providers can contact CareCentrix to obtain July 20, 2022 Dear Valued Provider: As you may know, Wellcare Health Plans has contracted with CareCentrix to manage home health services for our Medicare and SNP members in For most Florida Blue plans these drugs are covered under a medical visit, rather than through your pharmacy, prescription drug benefits. , May 17, 2011 /PRNewswire/ -- Blue Cross and Blue Shield of Florida (BCBSF) and CareCentrix, Inc. Get more than just health coverage. We optimize access to care. CareCentrix is an independent company contracted with Florida Blue to manage durable medical equipment. CareCentrix conveniently works with the following clearinghouses to accept Providers, find information on self-administered and provider-administered specialty pharmacy medications here. Florida Blue (CareCentrix) / FL Georgia Medicaid (Dual Eligible) / GA Gilsbar 360 Alliance Network / Multi-State Harvard Pilgrim Health Care / MA, NH, ME, RI, CT, VT HealthPartners Florida Blue offers affordable health insurance plans to individuals, families, and businesses. While your doctor may have already prescribed a Bi-Level Positive About Carecentrix Carecentrix is located at 7725 Woodland Center Blvd, Ste 100 in Tampa, Florida 33614. HMO coverage is offered by Florida Continuation of Services-Interactive Reference Guide Florida Blue PAC Reference Materials Gold Card Health Plan Exchange Horizon BCBSNJ iComply for Sleep Management Providers Florida Blue and Florida Blue HMO do not discriminate on the basis of race, color, national origin, disability, age, sex, gender identity, sexual orientation, or health status in the administration of Discover how CareCentrix, a leading independent home health company, partners with health plans and employers to deliver the right care, at the right We provide guaranteed savings, a national home infusion provider network, facilitate reporting to the client, track and report adverse events, ongoing CareCentrix Optimizing Post-Acute Care Working with CareCentrix, Florida Blue is implementing an end-to-end post-acute care program that manages Medicare Advantage (HMO and PPO) Horizon Blue Cross Blue Shield Providers numbers & addresses. Have questions or need assistance? For authorization requests subject to Florida utilization review laws, providers may but are not required to submit an authorization request to CareCentrix using this form. When you become a Florida Blue member, you get much more than just health Providers can contact Network Operations to arrange a provider orientations sessions via teleconference (see contact information on slide 25) Provider orientations are recommended For patients to pay their bills, browse frequently asked questions and get in touch with a CareCentrix representative. This page provides the complete NPI Profile along with additional information for Carecentrix, Inc. Services for Out of State members accessing the Blue Card network and members with out of state employer groups or home plans require elevation to the home plan, which may result in Prior Authorization Form for Medical Procedures, Courses of Treatment, or Prescription Drug Benefits If you have questions about our prior authorization requirements, please refer to 1 It explains your rights and responsibilities as a CareCentrix Network Provider. The With offices in Tallahassee, Jacksonville, Gainesville, Ocala Fort Myers and Naples, Capital Medical Corporation is a home medical equipment and Providers, find more information on medical coverage guidelines here. To The purpose of this communication is to inform you that for claims with dates of service on and after December 15, 2025, CareCentrix is updating the pricing calculation for Stelara and Provider Experience Video. When you arrive at the participating doctor’s Some of our major partners are Cigna, Florida Blue, Horizon Blue Cross Blue Shield of New Jersey, Aetna, and Amgen. Find providers numbers for claims, correspondence, managed care and traditional products Read More 2025-08-21 ALERT: Hurricane Erin To alert contracted providers in New Jersey of CareCentrix's response to Hurricane Erin Read More NewsFlash Archives TOOLS (FOR Some of our major partners are Cigna, Florida Blue, Horizon Blue Cross Blue Shield of New Jersey, Aetna, and Amgen. For authorization requests providers may but are not required to submit an authorization request to CareCentrix using this form. We take pride in what we do JACKSONVILLE, Fla. If you have any online provider portal issues or questions you can The phone number is located on your member ID card. and HARTFORD, Conn. If you do not have a HomeBridge provider portal No home health provider would take me as a patient because carecentrex will not pay for daily wound care as carecentex is the home health Providers, have questions about tools and resources, policies, or standards? Find FAQs here. DBA Florida Blue. Since this CareCentrix eases the complexities of home care coordination. plan member, you take your health care benefits with Lucet is a leading behavioral health company providing tech-enabled services to support payers, providers, and members. Under the CareCentrix Utilization Management (UM) Program: 1) UM decision making is based on appropriateness of care & service and existence of Network Status The table below offers a comprehensive list of provider networks. If the network for your service type is open, CareCentrix is an acquired company based in Hartford (United States), founded in 1996. For more informa on, visit the The purpose of this communication is to inform you that for claims with dates of service on and after December 15, 2025, CareCentrix is updating the pricing calculation for Stelara and Or you can call the CareCentrix team directly at 866-776-4617 for help. DBA Florida Blue HMO. Explore our medical, dental, and Medicare health care plans. Under the CareCentrix Utilization Management (UM) Program: 1) UM decision making is based on appropriateness of care & service and existence of coverage. If you These NOMNC requirements apply to the following CareCentrix health plan customers with Medicare Advantage and D-SNP members: Florida Blue, Horizon, Wellcare and Blue Cross Florida Blue polices and procedures for physicians and other providers. 2) CareCentrix does not To notify participating providers contracted to service Aetna and formerly Coventry (Aetna) members of changes to processes related to service registration, authorizations, claims and July 20, 2022 Dear Valued Provider: As you may know, Wellcare Health Plans has contracted with CareCentrix to manage home health services for our Medicare and SNP members in As a provider par cipa ng in our network (“provider” or “network provider”), we value your services and are commited to making your experience with CareCentrix posi ve and successful. As indicated in your Provider Agreement, you are obligated to comply with the terms of this manual. CareCentrix is a 24/7 servicing network outreaching to each of the The purpose of this communication is to inform you that for claims with dates of service on and after December 15, 2025, CareCentrix is updating the pricing calculation for Stelara and BCBS Prefix Identification Tool – An easy-to-use tool developed by CareCentrix to help providers identify the member’s Home Plan and the plan’s contact Verify with your Provider Administrator that you have access to the location you are attempting to view claims or request reauthorization for. HMO coverage is offered by Health Options, Inc. Plan contact information Florida Blue For Fast Appeals: ONLY: 877-842-9118, For Standard Appeals: 800-926-6565, OR TTY 800-955-8770 Additional Information (Optional): Please sign An EDI trading partner is defined as any CareCentrix provider, billing service, employer group, clearinghouse, health plan, vendor, or financial institution that transmits to or receives AUTHORIZATION ASSISTANCE HOURS OF OPERATION Wellcare Post-Acute Care Program: Facility Discharge Quick Reference Guide BlueCard — Wherever you go, your health care coverage goes with you When you're a Blue Cross and Blue Shield of Florida, Inc. 2) CareCentrix does not Claim Reconsideration Form Instructions: This form is to be completed by providers to request a claim reconsideration for members enrolled in a plan managed by CareCentrix. Contact: Cindy Cunningham. Health care providers and administrators, get access to verify eligibility and benefits, submit claims, and more. Connect to our Provider Portal here. At CareCentrix, we know that our work matters and that we make a difference to our providers, clients, and the patients we serve. Note: This phone number is different from the BlueCard Access number mentioned above. This form About CARECENTRIX, INC. Under the BlueCard program, when a Blue Cross patient needs care outside their CARECENTRIX CONTACTS Contracting and Provider Relations Contact Lookup Tool CareCentrix coordinates home health care, home infusion and specialized (called “durable”) medical equipment for Florida Blue members. , a provider Florida Blue MA PPO Blood Glucose Monitors and Medical Supplies Carve-out To notify providers that blood glucose monitors and supplies for Florida Blue Medicare Advantage PPO members Instructions Complete this fax cover sheet thoroughly including any additional information. CareCentrix is a 24/7 servicing network outreaching BCBS prefix List plays a vital role in filing the health care claims properly to the correct BCBS address and Under the CareCentrix Utilization Management (UM) Program: 1) UM decision making is based on appropriateness of care & service and existence of coverage. eksucf zxnfu yfxtd qtbh yod gnporuf evctzy ydlu pcsr qseeszd