CareFirst Upgrades Prior Authorization Notification System
Now Available for Commercial and Federal Employee Program (FEP) Members
Since April 2021, CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (CareFirst) has been preparing providers for the upgrade to Altruista, our new Prior Authorization (PA) Notification system, through different communications (BlueLink) and training efforts (live webinars, where over 700 providers participated.)
Effective today, the new PA Notification system is now live for Commercial and FEP members. The newly enhanced system offers easy to read dashboards, a user-friendly interface and electronic communication with CareFirst clinical staff.
Note: This upgrade was released in 2021 for Medicare Advantage (MA) members, and was effective January 1, 2022, for Group Medicare Advantage members.
What Does This Mean for You?
Entering authorizations will look a little different.
- After logging into the provider portal (carefirst.com), you can access the new system by selecting the Prior Auth/Notifications tab.
- To enter an inpatient notification and/or outpatient authorizations for Commercial/FEP/MA members, click on “Start Now” within the Medical (Commercial/FEP/Medicare Advantage)
- You will be taken to the new PA notification system (known as Altruista Health) to complete your request.
Does the launch of Altruista impact the new UM flexibilities announced last week?
No, the changes announced last week do not impact the launch of the new PA Notification system. All notifications can now be entered through Altruista using the timeline announced last week. For more details on the UM changes, refer to the email titled Utilization Management Flexibilities.
What Training is Available?
CareFirst has been offering two different types of training to assist you with entering PAs and notifications for Commercial/FEP/MA members.
- Live Webinars (Includes separate sessions for Institutional/Ancillary and Medical/Professional Providers)
- On-Demand Training and Interactive User Guides
Our webinars include an overview of the requirements, a detailed step-by-step review of the process along with other important information. We will continue offering webinars through the end of January.
If you haven’t had the opportunity to participate in a live webinar, register today by clicking the link and selecting the date and time of the session you would like to attend. You only need to attend one session.
Our on-demand training and interactive user guides are available 24/7. Visit our Courses by Topic page and select the Authorizations section.
You can find all this and more at carefirst.com/providereducation.