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Proveedores de Servicios Médicos

The Department of Financial Services (DFS) reviews alleged prompt pay claim payment violations pursuant to s. 627.6131 y 641.3155, Florida Statutes. A summary of the timelines insurance companies and Health Maintenance Organizations (HMO) are required to meet is available under "Additional Information". Claims not paid or denied by the insurance company or HMO in accordance with Florida regulations should be submitted with written documentation indicating the claims were received by the health plan.

Si se determina que su reclamación se encuentra dentro del alcance de la autoridad regulatoria del DFS, se le pedirá que envíe hasta cinco de sus reclamaciones pendientes de cada compañía. Si fuera necesario, le solicitaremos reclamaciones o documentación adicionales.

Under s. 408.7057, Florida Statutes, claims which involve a dispute regarding whether payment should be made or the amount of a payment, should be referred to or by calling (800) 889-0549. More information can be obtained by visiting the AHCA’s website at Statewide Provider and Health Plan Claim Dispute Resolution Program FAQ | Florida Agency for Health Care Administration (

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Atención: Todos los Proveedores de Servicios Médicos

El DFS no tiene autoridad sobre los siguientes contratos:

  1. Contracts purchased in a state other than Florida. If the contract was purchased in a state other than Florida, you should contact that state’s Department of Insurance. You can access the appropriate state’s contact information on the National Association of Insurance Commissioners’ website at

  2. Self-insured federal government employee contracts.

  3. Self-insured Employee Welfare Benefit Plans established under the Employee Retirement Income Security Act (ERISA).

  4. Reclamaciones por servicios Odontológicos Prepagados (contractuales).

Información Adicional