Precertification Requirements
Medical
To request precertification for Simply Medicaid, Clear Health Alliance and Florida Healthy Kids:
• Phone: 1-844-405-4296
• Fax: 1-800-964-3627
To request precertification for Medicare Advantage:
• Phone: 1-844-405-4297
• Fax: 1-866-959-1537
Behavioral Health
Beacon Phone Numbers for Members and Providers:
- 1-844-375-7215: Medicaid
- 1-855-861-2142: Florida Healthy Kids
- 1-877-698-7787: Medicare
- 1-786-837-2850 :Providers wanting to join Beacon Network
Preauthorizations:
- 1-800-221-5487: IP, IOP, PHP, SIPP, RTC
- 1-844-375-7215: OP Medicaid
- 1-855-861-2142: FHK
Beacon Fax Numbers:
- IP, IOP, PHP, SIPP, RTC Preauthorization: We do not accept faxes for this LOC, only phone calls.
- 1-800-370-1116: Medicare Preauthorization
- 1-800-370-1116: Medicaid Outpatient Preauthorization
Join Network for Providers
- 1-786-837-2850
Crisis Calls for Members
- 1-844-375-7215, Press 9, Press 1 for English or 2 for Spanish, Press 9 for Emergency, will then be transferred to a clinician
Pharmacy
Check our preferred drug list
Services billed with the following revenue codes ALWAYS require precertification:
0632 — Pharmacy multiple sources
Medicare
Precertification is not required for physician E&M services for members of the Medicare Advantage Classic plan.
Long-Term Services and Supports
Providers needing an authorization should call 1-877-440-3738.
The following ALWAYS require precertification:
Elective services provided by or arranged at nonparticipating facilities
All services billed with the following revenue codes:
0023 — Home health prospective payment system
0570–0572, 0579 — Home health aide
0944–0945 — Other therapeutic services
3101–3109 — Adult day and foster care
Precertification Tool
To request or check the status of a precertification request or decision, please login to Availity.