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Providers & Physicians Home CareFirst Provider

WEBThe largest provider network in the region and a commitment to value-based, preventative care for all. Learn more about what partnership means to CareFirst. Learn more with our …

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URL: https://provider.carefirst.com/providers/home.page

Quick Reference Guides

WEBRequired Documents for Dental Credentialing. Guidelines for Provider Self-Services for Dental Providers. Dental Clinical Criteria. Dental Reference Guide for Required …

Category:  Health Go Health

Provider Portal (CareFirst Direct) Upgrade CareFirst BlueCross …

WEBServing Maryland, the District of Columbia, and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, …

Category:  Health Go Health

Provider Quick Reference Guide

WEB877‐228‐7268. Send claims to your local plan: Mail Administrator P.O. Box 14116 Lexington, KY 40512. Mail Administrator P.O. Box 14114 Lexington, KY 40512. …

Category:  Health Go Health

Clinical Resources

WEBClinical Resources. CareFirst's Quality Improvement (QI) program seeks to enrich clinical care and administrative services in every area of the health care delivery system. …

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Professional Provider Manual

WEBChapter 3: Provider Network Requirements: Administrative Functions. Credentialing. Practice Transformation. Provider Scorecard. Role of the Primary Care Provider (PCP) – …

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CareFirst Direct CareFirst BlueCross BlueShield

WEBCareFirst Direct. CareFirst Direct is a free, convenient tool that gives you fast access to the information you need. With CareFirst Direct, you can: Make inquiries on your own time. …

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Patient-Centered Medical Home (PCMH) Overview

WEBPatient-Centered Medical Home (PCMH) CareFirst's PCMH program is designed to provide primary care providers with a more complete view of their patients' needs and of the …

Category:  Medical Go Health

Eligibility Help Information

WEBIf you have comments or questions, we want to help you. For technical support, call the CareFirst Help Desk at (877) 526 – 8390, Monday - Friday, 7:00 a.m.-6:00 p.m. (Eastern …

Category:  Health Go Health

CareFirst Acquires Trusted Health Plan in Washington, D.C. and …

WEBCareFirst has acquired Trusted Health Plan (Trusted), a managed Medicaid plan serving approximately 35,000 members in Washington, D.C. There will be no …

Category:  Health Go Health

Institutional/Ancillary Credentialing Overview

WEBProviders have the right, upon request, to review the information used in credentialing decisions, to correct inaccurate information and to obtain the status of the credentialing …

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Professional Reference Card

WEBCareFirst on Call Professional Reference Card Commercial: 800-842-5975 202-479-6560 NASCO Service and Out-of-Area Claims: 877-228-7268 FEP (Northern VA, DC, …

Category:  Health Go Health

MedStar Select Plan Update

WEBContact CareFirst’s Mental Health and Substance Abuse line at 800-245-7013. Select option 2 for assistance with mental health support services and care …

Category:  Health Go Health

Looking for support

WEBWe have a dedicated team here to help. You can leave a detailed voice message for Provider Relations at (410) 872-3512 or (833) 939-4107 Please include the following: …

Category:  Health Go Health

Leadership Biographies CareFirst BlueCross BlueShield

WEBServing Maryland, the District of Columbia, and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group …

Category:  Health Go Health

Behavioral Health Request for Authorization Form

WEBUtilization Management Behavioral Health Request for Authorization Form. For all Mental Health (MH) and Substance Use Disorder (SUD) service requests, please complete all …

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Provider Manual Administrative Support Breaking News …

WEBPayment Policy Updates. The policies listed below will be available to review in full via the Payment Policy database as of May 1, 2024. Many of these policies are documentation …

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Inquiries & Appeals

WEBPlease mail your Appeals to the following addresses: Professional Providers Mail Administrator P.O. Box 14114 Lexington, KY 40512-4114. Institutional Providers Clinical …

Category:  Health Go Health

PRIOR AUTHORIZATION CRITERIA

WEBFortamet,Glutmetza Policy 1517- A07-2017 CVS Caremark is an independent company that provides pharmacy benefit management services to CareFirst BlueCross BlueShield and …

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SPECIALTY GUIDELINE MANAGEMENT

WEBReference number(s) 2989-A Fibryga 2989-A SGM P2020 © 2020 CVS Caremark. All rights reserved. This document contains confidential and proprietary information of CVS

Category:  Health Go Health

Electronic Capabilities

WEBThe vendor is solely responsible for the services it provides.): ChangeHealthcare at (866) 506-2830. Medical and Hospital EFT Enrollment Forms | Change Healthcare. Availity at …

Category:  Medical Go Health

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