- If you cannot complete your eligibility/benefits inquiry online, please contact us at 800-842-5975.
- CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri,Oct 11 at 9:30PM to 11:30PM for all members.
- Due to a planned system upgrade beginning Friday, October 11 at 8:00 PM, and continuing through Monday, October 14 at 8:00 AM, you may experience a delay in your information appearing on CareFirst portals. We expect that changes to member data will be reflected on the portals by Wednesday, October 16. Your patience is appreciated.
How To Apply
Medical Network Application Process
The application process includes two important steps.
- As CareFirst utilizes the Council for Affordable Quality Healthcare (CAQH) ProView® solution as our Credentialing Verification Organization, register with CAQH and log into CAQH ProView®.
- Complete the appropriate CareFirst Questionnaire based on your provider type/need.
Your application cannot be reviewed until all steps are completed. The information below includes everything you need to know to complete this process.
Professional Providers
- Document your CAQH Identification Number.
- You will need this to complete step 2.
Complete the CareFirst Questionnaire
If you are a professional practitioner:
Or select from the following specialties:
You must complete this step and upload all required documentation for your application to be considered complete.
Examples of information needed to complete a CareFirst Questionnaire (see individual questionnaires for more details):
- Applicable Group Tax IDs and Billing NPIs
- W9, if applying as a new group or new solo/individual practice
- A complete list of applicable practitioners, including CAQH IDs or Rendering NPIs
- An electronic copy of licenses and insurance policies
Important Note: Be sure to save your CAQH Proview authorization settings to reflect the desired organization access. If you choose to review each payor’s request individually, please first contact CareFirst directly at 410-872-3500 or our toll-free number at 877-269-9593 to be added to the CAQH roster before beginning the CareFirst CAQH questionnaire.
Keep your Information Up to Date
The CareFirst Provider Directory is the single most used resource available to our CareFirst members. It is where they go to find a doctor to meet their healthcare needs. It is important to you and your patients (future and current) your information in our directory is accurate. If not, patients get very frustrated trying to find a doctor in their time of need.
- CareFirst Directory Data: CareFirst’s self-service tool is not integrated with CAQH ProView. Federal law requires all providers to attest and/or update their directory information at least every 90 days with CareFirst directly. For more information on how to access and utilize CareFirst’s self-service tool, review the Update Your Practice Info page.
- CAQH ProView Application: Once you are registered with CAQH, please continue to review, and make regular updates any time your credentialing information changes (or at least once each quarter). You will be sent a reminder from CAQH to review, update, and attest your data.
Dental Network Application Process
If you are interested in applying for our dental networks, visit the Dental Credentialing page to apply.