- 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.
- Billing NPI Reminder:The billing NPI submitted on claims must match the billing NPI on file with CareFirst,NPPES and for CareFirst CHPMD providers, ePREP and, beginning 10/13/2026,MPRIME.If your billing NPI is not enrolled with CareFirst, please go to:Adding a New Billing NPI
Change Healthcare notifying individuals of data breach. Learn more here.
Take Control of Your Provider Data — Now Easier Than Ever
The enhanced Provider Updates & Attestation tool in the CareFirst Provider Portal puts provider data management at your fingertips—quickly update and attest your information, confirm your network participation, add new practitioners to your group, and more, at your convenience.
Utilization Management Process Improvements
We’re improving UM fax intake-fewer forms, fewer fax numbers and easier submissions when unable to submit electronically.
Learn more
2026 Quality Toolkit Available Now!
The Quality Toolkit is designed to support providers in improving their quality measures, compliance and documentation.
Medicare Advantage: Electronic Payment Enrollment Through Zelis
We have partnered with Zelis for providers to receive electronic claims payments and remittance information.
Select 'Register' or 'Login' above to verify eligibility and benefits, check claims status, verify prior authorization requirements and submit requests, access remittance information, fee schedules and more at your convenience 24/7.
Helpful resources available on the Learning and Engagement Center.
CareFirst Healthy DC Resources Provider Quick Reference Guide Medicare Advantage Reference Guide Member ID Card Guide Provider Billing Self-Service Guide Provider Link List Provider Newsletters
Use our Provider Support Tool to quickly access the resources, services, and contacts you need - without having to pick up the phone or search through multiple pages of information.
Why CareFirst?
The largest provider network in the region and a commitment to value-based, preventative care for all. Learn more about what partnership means to CareFirst.
Provider Credentialing
Healthcare Transformation
- New Medications Requiring Approval & Site of Care Management Updates Effective October 1, 2026
- CareFirst CHPMD Providers – New Electronic Medication Prior Authorization Submission Process Effective September 1, 2026
- Effective September 15, 2026: Prior Authorization Requirement Update for PT, OT and SLP Services for CareFirst BlueCross BlueShield Medicare Advantage Members
- Quality, STARS and Risk Adjustment Updates
- Payment Policy Updates
