• Overview
• Authorization for Service
  • Referral Department
  • Case Management Department
  • Request a HMO Pre-Authorization
  • Request POS or Triple Option Pre-Certification
  • Refer a Member for Complex Case Management
• Claims
  • Medicare Part D Vaccines
  • Submit Paper Claim
• Coding
• Contracting with Florida Health Care Plans
• Credentialing
• Provider Handbook
• Provider Relations
• Referral Guidance
  • Laboratory Orders for all Networks

Credentialing

The following forms are available for your reference.To access the document(s) Adobe Reader® must be installed on your computer. If you do not have Adobe Reader ®, you can download it for free by clicking here.

• Credentialing PreApplication
• Credentialing Release of Information

FHCP requires that practitioners and facilities rendering care to FHCP members under a Health Service Agreement with FHCP have their credentials documenting their ability to render such services reviewed and approved by the FHCP Credentialing Committee.

When a new practitioner is added to an existing practice, the new practitioner MUST BE CREDENTIALED prior to rendering services to any FHCP member. Services rendered by practitioners who are not credentialed will not be covered by FHCP.

All providers, both practitioners and facilities that are listed in the FHCP Provider Directory, must be credentialed by the FHCP Credentialing Committee. This will include all practitioners that are participating providers and that provide covered health care services to consumers; including:

• MD's
• DO's
• Dentists (DDS, DMD)
• Oral Surgeons (MD, DDS, DMD)
• Podiatrists (DPM)
• Chiropractors
• Optometrists

Practitioners who are hospital based but are credentialed because of an independent relationship with FHCP include:

• Anesthesiologists with pain-management practices
• Faculty who are hospital based and who also have a private practice

Non-Physician Practitioners include:

• Nurse Practitioners
• Nurse Midwives
• Physician Assistants
• Behavioral health care practitioners including:
  • Doctoral or Masters Level Clinical Psychologists
  • Master's Level Clinical Social Workers
  • Licensed Mental Health Therapists