- We are working to resolve an issue that may impact how Harford County Public Schools benefits display. Member coverage is still active; however, benefit details may not appear correctly at this time. For benefit details or help, please call Provider Service using the number on the back of the member ID card
- EFT Payments Issued as Checks:CareFirst identified on or around May 10 an issue in which some providers who were set up to receive ACH/EFT payments instead received paper checks. This issue remains under active investigation. Providers do not need to take any action at this time. We are working toward resolution and will continue to share updates as more information becomes available, including expected timing.
- ERAs Reflecting Check Information Instead of ACH:CareFirst is aware of an issue in which some Electronic Remittance Advices (ERAs) reflected check payment information instead of ACH/EFT details. This issue was resolved on May 29, 2026. CareFirst is currently working to reissue impacted ERAs to include the correct ACH/EFT information. Providers do not need to take any action at this time.
Medicare Secondary Claims
Effective October 2013, the Blue Cross Blue Shield Association (BCBSA) implemented new regulations governing the submission process of Medicare Secondary claims.
Regulation Requirements
- Wait 30 days from the Medicare Explanation of Benefits (EOB) date before submitting your secondary claim.
- If you are submitting a secondary claim electronically (professional providers only), you must include the Medicare EOB or remittance advice date.
- Out-of-area member claims for covered services are now rejected by the member's home plan. When you receive a rejection notification, you must resubmit these claims to CareFirst for processing through BlueCard®.
- Medicare claims billed using a 'GY' modifier can be submitted directly to CareFirst without prior submission to Medicare. These claims are not impacted by the 30 day requirement and do not require the inclusion of a Medicare EOB.
How to Submit
All professional and institutional providers should submit Medicare Secondary claims electronically. If a paper claim is submitted, it must be accompanied by a copy of the Medicare EOB.
Electronic claims will need to contain specific information in the 837 claims transaction set. View the 837 Companion Guide for details.
Claims received without the required information will be returned at the front-end with one of the following messages:
- 53815 or 53818 - Missing Primary Payer payment information
- 53816 - Adjustment cannot be sent electronically
- 53817 - Invalid Primary Payer Information
- 53819 - Provider must accept assignment to send Medicare Crossover electronically
View the chart for additional information on the front-end rejections. The rejection verbiage may differ depending on the trading partner.
As a reminder, you should always check CareFirst Direct or CareFirst on Call for claim status before submitting a secondary claim.