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Webrequest to access PHI records. Florida Blue . ... FL 32203-4283 . Fax: 904-997-5586 . REQUEST A COPY OF PHI RECORDS FOR: Name of person for whom PHI records … WebFax Number ( ) Contact Name . 2. Patient Information . Patient Last Name : ... (medical records, operative report, inpatient or emergency room face sheet, etc.) See applicable instructions for your appeal type. ... Blue Cross and Blue Shield of Florida . Provider Disputes Department . P.O. Box 43237 . Jacksonville, FL 32203-3237 ... theory of mind nederlands
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