Clinical Resources

CareFirst's Quality Improvement (QI) program seeks to enrich clinical care and administrative services in every area of the health care delivery system. Clinical resources are developed under our QI program and support our providers in treating chronic disease, providing preventive care and maintaining office operations.

All of our guidelines are based on national medical association and health organization recommendations, approved by a Quality Improvement Advisory Committee of physicians and reviewed annually or when national guidelines change.

Documentation and Office Standards

D.C. Minor Consent for Vaccinations Amendment Act of 2020

Effective March, 19, 2021, the D.C. Minor Consent for Vaccinations Amendment Act of 2020 allows minors, 11 years of age or older, to receive a vaccine, if the minor is capable of meeting the informed consent standard and the vaccination is recommended by the U.S. Advisory Committee on Immunization Practices (ACIP) and provided in accordance with the United States Advisory Committee on Immunization Practices’ recommended vaccinations schedule.

Providers are not required to administer vaccines to minors without parental consent, however, should they elect to do so, the vaccine must be administered in Washington D.C. For proper reimbursement and suppression of the corresponding Explanation of Benefits, providers must complete both the D.C. Minor Consent Notification Form and the appropriate paper claim form. Both completed forms should be submitted by mail to: CareFirst BlueCross BlueShield, Privacy Office, PO Box 14858, Lexington KY 40512.

Paper Claim Forms to include:

  • Professional claims - please use the current version of the CMS-1500 form (version 02/12) on original red-ink-on-white-paper.
  • Institutional claims - please use the current version of the UB-04 form.