PROVIDERS

Resources & Tips

We’re grateful for the tremendous care you provide to our members, and we want to make that as easy as possible for you. If you have any questions, call us at (888) 897-1887.

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: 

Need to check 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:

Here is a list of services that require prior authorization.

Pharmacy: Our partners at CapRx 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.