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Request Form

Please complete and submit the following form. Most cases are resolved in 3-5 business days. Ask Medicaid Florida will use your last name and today's date (00/00/0000) as your case number. We will respond to your case via the email you provide. Ask Medicaid Florida staff may contact you if additional information is required. We appreciate your patients and the opportunity to serve you. We do NOT accept or approve Medicaid Florida applications. Feel free to ask additional questions before you start. 

RN, Biller, Coder, Claims Specialist, etc

Please ensure all information is accurate.

Which best describes you?
Reason for submission
I am a Florida resident or business
Total Cost
$19.95
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