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900-521-1114 1 Instructions for the Provider Clinical Appeal Form Physicians and Providers may question the outcome of how a claim processed via a provider appeal.
Form 4172 Revised 05/16 In the case of an emergency, it is imperative that the @%!!&& be able to reach the student’s parent (as defined below).
5 . Important Information Regarding the Use of this Manual Welcome to the Florida Blue Manual (Blue Cross and Blue Shield of Florida, Inc.) or Florida Blue HMO