What Third-Party We believe that the doctor-patient relationship is critical to good patient care. Check out our Coronavirus Resource Center for up-to-date benefit changes, including billing updates and new claims submission requirements. You only need to attend one session. . If you need to reach us for any reason, you can contact us in a variety of ways. If you are using the following browsers to access functionality within the Provider Portal, you may experience technical issues: Viewing and printing this document requires Adobe Acrobat Reader, which can be downloaded free from the Adobe site. CareFirst Community Health Plan Maryland (CareFirst CHPMD) will implement emergency room auto pay criteria to determine payment to hospitals. Preview / Show more . In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). Provider Services Department 1-410-779-9359 or 1-800-730-8543 Monday - Friday | 8:00 AM - 5:00 PM ProviderMD@CareFirst.com Appeals and Grievances . Once you have your claim form: Complete and sign the form. See Also: Carefirst medicare advantage phone number Show details Paper using a CMS 1500 or UB04 Mail paper claims to: CareFirst Community Health Plan Maryland PO Box 9121 Canton, MA 02021 If your concern is not resolved through a discussion with a CareFirst BlueChoice representative, you may submit a written appeal. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. Call Enrollee Services (202) 821-1100. Member Service Phone Numbers (Monday-Friday, 8 a.m. to 6 p.m.) Members who bought ACA Plans directly from CareFirst (off exchange) 855-444-3122 Members who bought ACA Plans through State Websites (on exchange) 855-444-3121 Members with Grandfathered/Non-ACA Plans 800-722-2467 Medigap Members 800-722-2235 CareFirst CHPMD offers ePayment which replaces paper-based claims payments with electronic fund transfer (EFT) payments that are directly deposited into your bank account. World's Most Ethical Companies" and "Ethisphere" names and marks are registered trademarks of Ethisphere LLC. . Contact our Credentialing Department to become a participating provider. We believe that all health care is delivered locally and supporting our provider network is critical to our success. For Providers. Send us your questions and we'll reply within one business day. The Blue Cross and Blue Shield and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. If you have questions about the auto-pay list, please email our Provider Relations Department at ProviderMD@CareFirst.com. Once enrolled you will be able to search, view and print images of the Electronic Remittance Advice (ERA) or download HIPAA formatted 835 ERA files to simplify payment posting. Let me give you a short tutorial. Find your provider representative. Find out about our online tools to save you time. For technical support, call the CareFirst Help Desk at (877) 526 - 8390. Our service area includes the following counties and city: Anne Arundel, Baltimore, Baltimore City, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Harford, Howard, Kent, Montgomery, Prince Georges, Queen Annes, Somerset, St. Marys. Send an Email Contact Info. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. Contact Change Healthcare (formerly EMDEON) at (866)-369-8805 For correspondence about claims submissions: Providers outside the CareFirst service area (Maryland, D.C. and portions of Northern Virginia) should submit all claims and correspondence to your local Blue Cross Blue Shield Plan. We want to hear it. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. If you would like additional information relative to CareFirst Community Health Plan Marylands claims submission guidelines, please call our Provider Relations Department at 800-730- 8543. Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc. and CareFirst Advantage DSNP, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. Sign up to receive provider news and updates at www.carefirst.com/stayconnected. Address 1100 New Jersey Ave, SE Suite 840 Washington, DC . . Contact our Credentialing Department to become a participating provider. Serving Maryland, CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. an independent licensee of the Blue Cross and Blue Shield Association. Learn about handling patient claims. CareFirst Administrators is the business name of CFA, LLC which is an independent licensee of the Blue Cross and Blue Shield Association. for Employers, Resources for Learn more about CareFirsts NPI requirement for claims submission. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. For technical support, call the CareFirst Help Desk at (877) 526 - 8390, Monday - Friday, 8:00 a.m.-6:00 p.m. (Eastern Time). CareFirst CHPMD is a Medicaid Managed Care Organization serving members in the Maryland HealthChoice program. CareFirst Administrators (CFA) and its provider partners serve the one in three Americans who chooses Blue. Go to Carefirst Blue Cross Sign In website using the links below Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. Suggest a topic for our learning and engagement center. Read! If you need further assistance, contact the CareFirst Help Desk at 1-877-526-8390 or send an e-mail to edidirectsubmission@carefirst.com. Employers, CFA and Brokers: Enhancing the Partnership, Learn More about Third-Party Administrators. CareFirst is closely monitoring the coronavirus situation and working in close partnership with state and local public health authorities. Join Our Networks. Paper using a CMS 1500 or UB04Mail paper claims to: CareFirst Community Health Plan MarylandPO Box 9121Canton, MA 02021. Step 1. If you have comments or questions, we want to help you. Next, select the appropriate form for your claim (medical, dental, etc.). Providers can obtain additional information about submitting claims through Change Healthcare by calling 866-506-2830 or visiting the website at https://cda.changehealthcare.com/Portal/ Paper Claims. Complete our simple feedback form or email us. Click here to register for an upcoming webinar. Ask CareFirst Call Us: 844-439-6482 Phone support is available from 8 a.m. to 9 p.m. EST Monday-Friday. Medicare Advantage Plan Resources CareFirst. Below is a list that may assist you with your CareFirst provider-related questions. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). Feel free to leave a secured voicemail or email us at CHPMDMembers@CareFirst.com. CareFirst CHPMD reserves the right to audit claims in accordance with Maryland regulations for consistency between clinical documentation and information presented on the bill (including the reported diagnosis). Or, visit Contact Us to find a department/resource list to assist you. Solutions Information Medicaid coverage is automatically given to individuals receiving certain other public assistance, such as Supplemental Security Income (SSI), Temporary Cash Assistance (TCA), or Foster Care. If you're unsure, contact your insurance provider directly and ask about the treatment option you want to get covered. You can also contact us by mail: CareFirst BlueCross BlueShield Medicare Advantage P.O. Live webinars (hosted using Microsoft Teams) will begin on June 14, 2022 and will be offered 3 times a week. CareFirst Community Health Plan Maryland ATTN: CLAIMS ADJUSTMENTSPO Box 915Owings Mills, MD 21117, Emergency Room Auto-Pay InformationEffective January 2017. for Current Clients. Submit claims for office visits, urgent care, or ER visits for the purpose of diagnosing or ordering testing for COVID-19 using ICD-10 primary diagnosis code of Z20.828 regardless of the place of service. Is there a telephone number that I can call regarding problems with my electronic claim submissions? Don't miss. Box 3236 Scranton, PA 18505 By Phone Speak to a licensed sales agent by calling 833-987-0765 (TTY: 711) Monday through . Contact CareFirst If you need to reach us for any reason, you can contact us in a variety of ways. Claims for CareFirst Community Health Plan Maryland (CareFirst CHPMD) members may be submitted in one of the following methods: Electronically (preferred method) through our Clearinghouse, Change Healthcare (formerly Emdeon) Payor ID 45281. Administrators Can Do Or, refer to the chart below for more information about provider resources and services. Is CareFirst Administrators Answer: Please direct questions to your vendor or clearinghouse first. Voicemail messages and emails are returned the next business day. Use the following ICD-10 reporting codes for billing COVID-19 treatment: Treatment of coronavirus- use code U07.1 as primary diagnosis code For technical support, call the CareFirst Help Desk at (877) 526 8390, Monday - Friday, 8:00 a.m.-6:00 p.m. (Eastern Time). At CareFirst CHPDC, we stand by our providers in offering exceptional health care to DC locals and their families. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. CareFirst Community Health Plan Maryland (CareFirst CHPMD) works with our network of over 7,000 physicians and health care providers to deliver the best quality care to our members. Find the latest information. Frequently asked questions about handling patient claims and using this website. Have feedback on our website? It is only by partnering with providers, such as yourself, that we can truly achieve those goals. Just Now CareFirst BlueCross BlueShield Medicare Advantage P.O. Find seminars, webinars and other training opportunitiesfor you and your staff. Our service area includes the following counties and city: Anne Arundel, Baltimore, Baltimore City, Calvert, Caroline, Carroll, Cecil, Charles, Dorchester, Frederick, Harford, Howard, Kent, Montgomery, Prince Georges, Queen Annes, Somerset, St. Marys, Talbot, Wicomico and Worcester. Register today. To appeal a claim payment or denial, follow these steps: Step 1: Contact Us Call the Member Services phone number on your member ID card. Serving Maryland, CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. an independent licensee of the Blue Cross and Blue Shield Association. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. seminars, webinars and other training opportunities, Surprise Billing - Out-Of-Network Provider Notice, Internet Explorer 11, Microsoft Edge 14 (Windows 7, Windows 8.1, Windows 10)or higher. Access the Provider Portal to: View patient's eligibility status and benefit information Check claims Download forms Access the CareFirst online medical policy reference manual. (CFA) Right for You? (NCDAS) claims the average cost of drug . Important information for providers, including the CareFirst online medical policy reference manual. To print and mail your claim form, log in to My Account; choose the Plan Documents tab, then Forms. Use the links below to access information on submitting claims and processing billing with CareFirst CHPDC. Prospective Member: 1-844-331-6334 (TTY: 711)October 1 - March 31 | 8 am - 8 pm EST | 7 days a week April 1 - September 30 | 8 am - 8 pm EST | Monday - Friday MyHealth Portal| Provider Resources| FDRS A list of services that require pre-authorization and how to submit. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. We believe that all health care is delivered locally and supporting our provider network is critical to our success. We believe that the doctor-patient relationship is critical to good patient care. Or, refer to the chart below for more information about provider resources and services. Verify Member Eligibility and confirm benefits, check claims status and update your provider information. Contact Us - CareFirst Medicare Advantage Contact Us, for questions, learn more information about CareFirst Medicare Advantage medicare plans. CareFirst CHPDC will be conducting live webinars and on-demand training to assist you in learning the new process for entering PAs and notifications for CareFirst CHPDC enrollees. CareFirst Community Health Plan Maryland (CareFirst CHPMD) works with our network of over 7,000 physicians and health care providers to deliver the best quality care to our members. Find out how to submit claims and get paid electronically. BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. If you're making this call, make sure to have as much information about the treatment provider available as you can. If you have comments or questions, we want to help you. Access it here. Box 3236 Scranton, PA 18505 Providers can obtain additional information about submitting claims through Change Healthcare by calling 866-506-2830 or visiting the website at https://cda.changehealthcare.com/Portal/. Providers can obtain additional information about submitting claims through Change Healthcare by calling 866-506-2830 or visiting the website at, Diagnosis (ICD10) code(s) and description(s, If you have questions about the auto-pay list, please email our Provider Relations Department at. Employment at CareFirst Fraud & Privacy Technical Support Individual Sales Inquiries Phone Numbers (Monday-Friday, 8 a.m. to 6 p.m. and Saturday, 8 a.m. to noon) Current members with renewal questions 855-300-7751 Individuals interested in purchasing insurance 800-544-8703 You can enroll over the phone, online or meet with a licensed sales agent today by calling: 1-844-331-6334 (TTY: 711) 8 AM - 8 PM EST, 7 days a week from October 1 - March 31. Policies and Operating instructions for all CareFirst products. Phone support is available from 8 a.m. to 9 p.m. EST Monday-Friday. From April 1 through September 30, our hours are 8 a.m.-8 p.m., ET, Monday through Friday. All claims, whether paper or electronic, should be submitted using standard clean claim requirements including, but not limited to: Claims must be filed within 180 days of the date of service or 180 days from the date the primary insurance paid. To have a claim form mailed to you, call Member Services at the phone number on the back of your member ID card. CareFirst Administrators (CFA) is the only third-party administrator in Maryland, D.C. and Northern Virginia providing flexibility and superior service, through the most trusted name in health carelocally through CareFirst BlueCross BlueShield, and nationally through the Blue Cross Blue Shield Association. Please include a written description of the issue and a reference to the initial claim. With the ease and convenience of CareFirst BlueCross BlueShield Advantage DualPrime's all-inclusive health coverage, you can spend more time doing what makes you happy. For technical support, call the CareFirst Help Desk at (877) 526 8390Monday - Friday, 7:00 a.m.-6:00 p.m. (Eastern Time). Understand when and how to submit to get a fast response. For additional information contact EMDEON at 800-506-2830. All requests for claims adjustments or reconsiderations must be submitted within 180 days of the date of remittance and mailed to the address below. CareFirst CHPDC is the Washington DC provider of Medicaid and Alliance Benefits. Visit the CareFirst Administrators Provider Home here. Send Us a Message Send us your questions and we'll reply within one business day. Quick links to all of your most important provider information. CareFirst insurance plans can generally cover a po. For more information, call Member Services at 855-290-5744 (TTY: 711) 8 a.m.-8 p.m., ET, 7 days a week from October 1 through March 31. How to login easier? If you have comments or questions, we want to help you. The Maryland Department of Health (MDH) provides Medical Assistance, also called Medicaid coverage to individuals determined to be categorically eligible or medically needy. Looking for CareFirsts provider page? 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