Posted on 2022-06-30 It is important that you know that we may make changes to We strive to make working with Anthem easy so that you can focus on providing excellent care to your patients. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. You can find previous issues of BlueLink at carefirst.com/bluelink. 1966 Greenspring D. rive, STE 100 Timonium, MD 21093 410-779-9359 | 800-730-8534 | TTY: 711 | ProviderMD@CareFirst.com www.CareFirstchpmd.com. Patient phone number. Medical policies, which are based on the most current research available at the time of policy development, state whether a medical technology, procedure, drug or device is: Operating procedures provide specific benefit information and/or instructions. CareFirst's bimonthly administrative provider newsletter for participating practitioners and their office staff. Search for your current providers to see if they are in-network for the avaliable plans in your area. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. You may add up to 3 providers to your provider list. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Reminder Attest/Update Your Provider Data, Working Together to Improve Member Data and Documentation, Referral Reminders for Federal Employee Program (FEP) and Skilled Nursing Facility (SNF), New Prior Authorization/Notification System Best Practices, Submit Your Blue High Performance Network, BlueCard Contiguous Counties Claims Filing Reminder, Announcing New Course: LGBTQ+ Cultural Competency, Review the Latest Changes to the CareFirst Provider Manual, Internet Explorer No Longer Supported on CareFirst Applications, Use the Find a Doctor Tool to Determine Your Network Participation. Pre-Service Authorization requests can be faxed to: (202) 905-0157. The process is simple and automated, and most employees are verified within 24 hours. The member's identification card will indicate where the member should be directed for these services. are in our network. Surprise Billing - Out-Of-Network Provider Notice, Maryland and D.C. Phone: 031-631178-9 , 0189-327555 EC21 is a. CareFirst BlueCross BlueShield. Are You Up to Date on Best Practices and Quality Standards? We put your care first. Effective Dates, Current Procedural Terminology (CPT) Codes and Policy Updates. 97152. The majority of services offered by THP do not require a Prior Authorization. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. CareFirst BlueCross BlueShield's Individual Health Plans offer the widest coverage and the largest network for medical, dental and vision insurance in Maryland, Washington, D.C. and Northern Virginia. If your state isn't listed, check out bcbs.com to find coverage in your area. Expand Affordability and Access for Members with Diabetes, ReminderAttest/Update Your Provider Data, Coming SoonNew Provider Payment Policy Database, Have a Question About Your Claim? Fee schedules have been updated so claims with approved telemedicine CPT codes and modifiers with POS 02 will be reimbursed at Updated on 2022-06-30 15:19:11, The latest issue of BlueLink is now available online at carefirst.com/bluelink. Prior to sending your requests, please be sure that eligibility is checked. Health insurance can be complicated. 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. H2012;. must Pre Surprise Billing - Out-Of-Network Provider Notice. In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. Oral notification will be made within 24 hours of the decision. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2022. What services require Prior Authorization? 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Opioids and Your Practice: New Resources Available, Check Out the Recent Changes to the Learning and Engagement Center, BlueCard Resources and Training Available, Genetic Testing Requires Prior Authorization, Attended Sleep Studies Require Prior Authorization, Medical Prior Authorization Helpful Hints, Medications Added to Prior Authorization and Site of Care Management Lists Effective June 1, 2022. In an effort to keep you informed of changes and improvements, we have updated our Professional Provider Manual. This list shows some common examples. OB care and services will be coordinated by a CareFirst CHPDC OB Case Manager. 15 minutes 32 units . Updates were made to the following sections: Administrative Functions: Update to Profile Score section to indicate when CareFirst may use the scores to create new networks. Search For Care Shop Insurance Plans secure provider portal: https://provider.wellcare.com . CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., First Care, Inc., The Dental Network and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association. You can also download and print the complete manual. CareFirst Expands its Available NetworksAre you In- or Out-of-Network? CareFirst Expands its Available Networks Are You In or Out of Network? review the 2022 Provider Directory to see if your providers (primary care provider, specialists, hospitals, etc.) As part of that goal, we It also lists them in alphabetical order. 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. However, plan notification of OB services is required. Where no NCDs or LCDs exist, CareFirst BlueCross BlueShield Medicare Advantage will apply industry standard and CareFirst medical policies. That's why we oer plans, comprehensive benets, and access to a large network of providers across the state. Posted on 2020-02-13 | Updated on 2020-02-13 17:57:41. Attn: Dental Provider Networks and Credentialing. Updated on 2020-02-13 17:57:41. CareFirst Expands its Available NetworksAre you In- or Out-of-Network? Here is How to Get Answers, CareFirst Provides Update on ClaimsXten Edits, BlueCard Contiguous Counties Claims Filing Reminder, Medications Added to Prior Authorization and Site of Care Management ListsEffective January 1, 2023, New Prior Authorization/Notification System Best Practices, Its Here! Patients address. Post service Authorization decisions, as expeditiously as the member's health condition requires and no later than 14 calendar days of receipt of the request for services with a possible extension of up to 14 calendar days. Use this form to let us know about corrections and we'll follow up. (855) 481-7041. Find a Doctor Weve got you covered with access to over one million doctors, hospitals and health facilities. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is an independent licensee of the Blue Cross and Blue Shield Association. The online Medical Policy Reference Manual contains approved medical policies and operating procedures for all products offered by CareFirst. These services include, but are not limited to: Emergency Services and Emergency Transportation do not require a Prior Authorization, but Plan Notification is encouraged as soon as possible. Call Now: 888-902-5707 TTY/TDD 800-955-8770 Chat with an Agent. Choose your state below so that we can provide you with the most relevant information. Patient identification number. ReminderUpdated HIPAA Verification for Member Security for Provider Service. Working Together to Improve Member Data and Documentation, Reminder Attest/Update Your Provider Data, Referral Reminders for Federal Employee Program (FEP) and Skilled Nursing Facility (SNF), Announcing New Course: LGBTQ+ Cultural Competency, Use the Find a Doctor Tool to Determine Your Network Participation. These documents are designed to help you and your office staff understand member eligibility, You can reach one by calling 1-877-890-1409 TTY Users: 711 24. 1. Lower Back Pain Imaging Kevin Schendel, M.D. Payment Changes Coming for Select Lab Services, What Providers Need to Know about the Consolidated Appropriations Act (CAA), Care Management UpdatesEffective January 1, 2022, No Charge Behavioral Health Digital Resource Now Available, How to Refer Your Patients to the High-Risk Obstetric Care Management Program. 988The New Hotline for the National Suicide Prevention Lifeline, ReminderUpdated HIPAA Verification for Member Security for Provider Service, Medications Added to Prior Authorization and Site of Care Management ListsEffective September 1, 2022, CareFirst Provides Updates on ClaimsXten Edits, Submit Your Blue High Performance Network. 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. Requests will not be processed if they are missing the member number, clinical information, CPT, ICD-10 codes and/or Physician Signatures. An Aetna Medicare formulary typically lists drugs grouped by the types of medical conditions they are used to treat. It looks like you're outside the United States. As part of that goal, we provide you with resources containing information to help your relationship with us run as smoothly as possible. We strive to make working with Anthemeasy so that you can focus on providing excellent care to your patients. You can also visit bcbs.com to find resources for other states It looks like you're outside the United States. It looks like you're in . CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site. If there is a form that you feel other providers would find useful to access on this page, please contact us at (202) 821-1145. www.RadMd.com or (888) 899-7804. (202) 821-1100, Hours of Operation 7. of . 1100 New Jersey Ave, SE Medications Added to Prior 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.). Doctor indicates he.she no longer accepts this insurance plan, Your District of Columbia Health Plan Partner, CareFirst CHPDC CLAS Training Video - Module 1, EPSDT Screenings and Special Services Training. Updated on 2022-02-28 10:29:47 Changes coming to Provider Portal. Lower Back Pain Imaging Kevin Schendel, M.D. Report incorrect info for www.carefirstchpdc.com. E-cigarettes and Gum Disease Cheryl Lerner, D.M.D. 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. 2022 Summary of Changes (PDF) . Nursing Home/ Skilled Nursing/Hospice Care. 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. Standard Non-Urgent Preservice Authorization decisions will be made no later than 14 calendar days of receipt of request for services, with a possible extension of up to 14 calendar days. CareFirst offers provider manuals and quick reference guides for use by network providers. Oral notification will be made within 24 hours of the decision. Surprise Billing - Out-Of-Network Provider Notice. Effective: April 13, 2022 Page . Provider Manuals Health insurance can be complicated. CareFirst offers provider manuals and quick reference guides for use by network providers. Blue Cross Blue Shield of North Dakota (BCBSND) posted 2022 North Dakota Medicaid Expansion professional fee schedules to the Online Fee Schedule Portal on Friday, December 10, 2021. We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Help us stay up to date. Community Health Plan District of Columbia, Address