Will Florida Blue Prompt Me When to Pay

Why Florida Blue Isn't Paying You Back

A Guide to Florida Blue Provider Enrollment

Florida Blue is one of the many insurance companies in the United States that requires out-of-network providers to complete paperwork before they will process out-of-network claims from your practice. If you don't complete this step, your patients' out-of-network claims will not be processed and they will never get their money back.

How Better Can Help Providers

In addition to our step-by-step instructions below, Better is also available to help you through the process. Our team is happy to answer questions and assist you at no cost. Email us at providers@getbetter.co if you have any questions.

The Application

In 2015, Florida Blue instituted a new policy requiring all healthcare providers — even those who take no insurance — to complete a Non-participating provider registration form. Completing this application adds you and/or your practice to Florida Blue's computer system. Without this Florida Blue will not process out-of-network claims from your practice.

Completing these forms does not enter you into a contractual relationship with Florida Blue, nor does it mean you are in-network. It simply allows your patients to get paid back for care.

One of the good things about Florida Blue is that you are able to complete the entire process online. You can do this through Availity. The Availity portal is an online tool that allows healthcare professionals to interface with a large number of insurance companies with one simple log-in.

If you do not yet have an Availity account, the first step will be to register. This only takes a few moments.

Once you have registered, log-in to your Availity account. Select "Payer Spaces" in the menu at the top of the screen and select Florida Blue.

You can then click on "Create a Provider Record with Florida Blue to Submit Claims" and begin the Non-Participating Provider Registration Form.

If you would prefer to complete the process offline, you can complete the PDF application. Once completed the form can be submitted:

Via Mail

Florida Blue Network Operations
P.O.Box 41109
Jacksonville, FL 32203

Via Email

FloridaBlueProviderVerification@FloridaBlue.com

The Florida Blue Provider Enrollment Process

The non-participating provider registration process collects information on your practice.

Before you begin, you will want to collect a few supporting documents:

1. A government issued photo ID: Florida Blue requires an image of your government issued photo ID such as a driver's license or passport. This is an unusual requirement that we do not see from many insurance companies but Florida Blue will not activate your provider record if this is not provided. (We've tried!)
2. A copy of your license: If you are a licensed healthcare professional, Florida Blue requires a copy of your license to be included with your application. Many insurers are now requiring this step.
3. A Type 2 (group) NPI if you use an EIN on your superbills: This is also an uncommon requirement. Florida Blue will only allow a Type 1 (individual) NPI to be linked to a social security number. If you are a solo provider but use an EIN (employer identification number) on your superbills, Florida Blue will require that you provide a Type 2 NPI in addition to your Type 1 NPI or that you switch to including your SSN on your superbills. We know this requirement is a headache! You can learn more on obtaining a NPI here.

Follow These Steps:

1. First, you will need to select the type of record you are creating. If you are a group practice, you will need to add records for both the group and each individual provider within the group separately.

2. Then follow the prompts to include information about your specialty, locations, hours, office staff, and licensure. As long as you have your photo ID and license handy, the questions are rather simple.

3. You are almost done! Review and submit your application. Florida Blue will get back to you once your application has been reviewed.

How to Get Help

If you would like to reach out to Florida Blue directly with questions you can send an email or leave a voicemail for their Provider Verification Unit.

Via Email

FloridaBlueProviderVerification@FloridaBlue.com

Via Phone

305–921–7001

We are also available to answer your questions and assist you in this application process free of charge. Email us at providers@getbetter.co if you have any questions.

Request brochures to share Better with your patients. The Better team is here as a free resource for providers to answer any questions you have about insurance, billing, or coding — email us at providers@getbetter.co !

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Source: https://blog.getbetter.co/why-florida-blue-isnt-paying-you-back-d57e109a4692

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