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First Coast Advantage (FCA) now has the capability for Providers to submit their Medical Pre-Authorization Request Forms for New and Updated Request On-Line. Providers can also download their patient clinical information directly to the FCA Pre-Authorization Department if you have scanning capability. This is a secure web link for pass through of patient information and no password is needed. The patient clinical information will go directly to FCA Staff and the information is not housed on the Internet or FCA Website. Currently, Behavioral Health Pre-Authorization Request will be handled through the normal paper process. Click Here for Behavioral Health Pre-Authorization Information.

Important Information

Recently, FCA changed the Pre-Authorization list for services that require pre-authorization. Click Here to the see the updated list.
Once a Provider submits their Pre-Auth Request, a box will appear with "Added New Record HAMI Tracking Number". This tracking number will be used as confirmation to track your submitted pre-auth.
Any requested information with a red *(asterisk) on the Pre-Auth Request form must be completed and the form will not be submitted if information is left blank.
If information requested is Not Applicable, to the request, please type N/A for the information requested, otherwise the form will not go through.
If Provider's Pre-Auth requires additional information or is missing information, the requesting Provider will get an e-mail informing them of what information is needed.
After fourteen (14) business days (Updated 10/11/11) of submission of all requested information, Provider will be able to view the approved or denied pre-authorization information on the FCA Secure Web Portal, where a password is needed.
All Out of Network (OON) Providers who submit a Pre-Auth request will get an e-mail back to the e-mail address that was included on the pre-auth request, with the determination of the request.

Provider's Without Scanning Capability

If a Provider does not have scanning capability they can still submit their pre-auth request on-line.
Complete the Clinical Fax Cover Sheet within your On-Line Pre-Auth Request or from the selection below and fax it to (904) 244-9744 with your required clinical documentation.
Provider On-line Pre-Auth Request will have a Tracking Number once submitted to FCA and this number will used as confirmation of the requested pre-auth. The Tracking Number must be included on the Clinical Cover Fax Sheet for FCA's Pre-auth Department to track and/or match the requested Pre-auth.
For questions contact FCA Provider Services at 1-866-270-2468 or e-mail FCA Pre-auth Department at pre.authorizations@jax.ufl.edu.

To Submit A Pre-Auth Select New or Updated Request Below: