Frequently Asked Questions
How do I check authorization status?
Which medical services require prior authorization?
How can I check a patient’s eligibility?
What does the Firefly member ID card look like?
It looks like this:
Does my practice accept Firefly?
We use First Health for our plan’s network. If you belong to First Health, you accept our plan, no problem.
How do I submit a claim?
How do I check claim status?
How do I find out why a claim was denied?
How quickly do you process claims?
Usually within 14 days.
How can I correct a claim?
When will I receive an explanation of payment (EOP)?
You’ll get it in the mail 7-10 days after we process the claim.
How much should I charge Firefly members?
My patient is showing me a Care Pass. Do they really have a $0 copay for my services?
Yes, they do. 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 1-888-897-1887.
How quickly will I receive payments?
Usually within a week of claims approval. Claims processing typically takes up to 14 days.
How do I find alternatives for medications that aren’t in your formulary?
How do I submit a pharmacy authorization?
Which drugs require prior authorization?
Where do I send mail-order and specialty prescriptions?
Mail-order: E-prescribe prescriptions to Costco Pharmacy #1348
Specialty: E-prescribe prescriptions to Costco Pharmacy #0134