florida health care plans east volusia area network referral instructions

GENETIC TESTING
All Genetic Testing for FHCP members must have prior authorization from the FHCP Referral Department in Daytona Beach. Please do not send
a FHCP member directly to a lab without prior authorization. Only requests that are medically necessary will be considered.
REFERRAL INSTRUCTIONS: Complete the FHCP Referral form. Attach pertinent documentation and dictation needed to substantiate this
request. Distribute the form as follows: White, Pink, & Yellow: Send to the Referral Department at FHCP’s Daytona Beach facility, via FHCP
courier. Blue: Give to the member.
The Referral Department will review the request and if approved, will schedule the member’s appointment with this specialist, record the
appointment date and time on the request form and return the completed Yellow copy to your office for your records.
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