Providers & Physicians Home | CareFirst Provider

Login

System Maintenance

Prior Authorizations/Notifications Update: You can expect authorizations for medically necessary procedures covered by the member’s benefits that are not experimental, investigational, or cosmetic in nature to be approved. These procedures should not be canceled.

Our UM team is prioritizing review of the most emergent authorizations. To help expedite this process, please do not resubmit the same authorization multiple times. Access training information here.

Coronavirus (COVID-19) Information

CareFirst is closely monitoring the coronavirus situation and working in close partnership with state and local public health authorities. Check out our Coronavirus Resource Center for up-to-date benefit changes, including billing updates and new claims submission requirements.

Find the latest information

We Stand Together Against Racial Injustice

Inequity and injustice are a devastating sickness. We stand alongside our Black members, employees, providers, partners and communities—committing ourselves to take action to ensure equity for each and every person in our society. Read more.

Medical Policy

Electronic Claims

Stay Connected

Quick Links

Medical Policy

Find approved medical policies and operating procedures for all products offered by CareFirst in the online Medical Policy Reference Manual.

Electronic Claims

Get paid fast and save time - submit your claims online.

Electronic Data Interchange (EDI)
Electronic Funds Transfer (EFT)
National Provider Identifier (NPI)

Stay Connected

Quick Links

Provider Features

The CareFirst PCMH Program

The CareFirst PCMH Program rewards primary care providers for delivering quality, cost-effective care. Read the complete Program Description and Guidelines or click “Learn more” below.

Learn more