How To Apply
Medical Network Application Process
The credentialing process includes three keys steps.
- First, register with CAQH and log into CAQH ProView®.
- Second, document the CAQH Identification number you receive once registered.
- Third, complete the CareFirst Questionnaire.
Your application cannot be reviewed until all three steps are completed. The information below includes everything you need to know to complete this process.
Step 1: Register with CAQH
- To start the credentialing process, you must register with CAQH. When you use CAQH ProView, you eliminate the need to complete multiple, lengthy paper forms and reduce administrative burden.
- For more information about how to use CAQH ProView, please view the CAQH Provider Quick Reference Guide as well as the 'CAQH ProView Help' section, and review their FAQs.
Step 2: Document your CAQH Identification Number
- Once you are registered with CAQH, you will be assigned a CAQH Identification Number. You will need to have your assigned CAQH Identification Number to complete Step 3.
Step 3: Complete the CareFirst Questionnaire
- You must complete this step for your credentialing application to be considered complete.
- Access the CareFirst Questionnaire to attest your profile and upload all the required documentation.
- The following information is required to complete the questionnaire:
- 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
- An electronic copy of 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 at our toll-free number, 877-269-9593, to be added to the CAQH roster before beginning the CareFirst CAQH questionnaire.
Attention Virginia Based Athletic Trainers: If you are interested in joining our network, please complete the Credentialing Application (PDF) form to initiate the credentialing process. Once completed, please mail the application to PO Box 14763, Lexington, KY 40512 or fax to 410-872-4107. Athletic Trainers should not utilize CAQH ProView. Keep in mind only Athletic Trainers affiliated with a participating group in Virginia are eligible to apply.
Paper Application: If you are unable to submit your credentialing application electronically, please fill out the Credentialing Application (PDF) form and send it back via fax at 410-872-4107 or mail to the following address: Mail Administrator, P.O. Box 14763, Lexington, KY 40512.
Keep your Information Up to Date
- Credentialing Application: Once you are registered with CAQH ProView, please continue to review and make regular updates any time your provider information changes (or at least once each quarter). You will be sent a reminder from CAQH to review, update, and attest your data.
- Provider Directory Data: CareFirst’s self-service tool is not integrated with CAQH ProView. All providers must attest and update their directory information with CareFirst directly. For more information on how to access and utilize CareFirst’s self-service tool, review the Update Your Practice Info page.
Dental Network Application Process
If you are interested in applying for our dental networks, visit the Dental Credentialing page to apply.