PROVIDERS
Resources & Tips
Check Eligibility
We use First Health for our plan’s network — that’s Aetna’s network. If you belong to First Health, you accept our plan, no problem. To check that a member has active coverage, call us at (888) 897-1887.
Submit Claims
Send claims electronically to Payer ID FH205. Or submit an HCFA 1500 (CMS-1500) form to Firefly Health PO Box #278 Arnold, MD 21012. Need to check a claim status? Call us at (888) 897-1887.
Request Authorizations
Medical: Our utilization management partners at MedWatch process medical authorizations for us. To submit an authorization, you can:
- Complete an online precertification form
- Call (888) 897-1887
Here is a list of services that require prior authorization.
Pharmacy: Our partners at Capital Rx process pharmacy authorizations for us. To submit an authorization, call (888) 897-1887 or submit a prior authorization form:
- Fax: 1-833-434-0563
- Mail:
Capital Rx, Inc.
Attention Prior Authorization Department
228 Park Avenue South, Suite 87234
New York, NY 10003-1502
Here is a list of drugs that require prior authorization.
Verify Care Passes
If a member shows you a Care Pass in the Firefly Health app, you shouldn’t charge them anything — their plan covers the full cost of their visit. This is how we reward members for seeing the high-value providers we recommend.
Just verify that your name or the name of your facility is on the pass. If you have any questions, call us at (888) 897-1887.
Need something else?
Check our frequently asked questions or call (888) 897-1887.