Change Healthcare Notice

Hold The Phone - Find What You Need on CareFirst Direct

Posted on 2022-08-16 | Updated on 2022-08-16 15:08:55

Use Self-Service Tools for Common Requests

At CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (collectively “CareFirst”), we understand that providers are busy and need answers quickly. Since we are experiencing higher than normal call volumes, you can find most of what you need online at CareFirst Direct, rather than wait on hold.

You can access the following information using self-service tools:

Function
CareFirst Direct
CareFirst on Call (IVR)
Applicable Training
Eligibility and Benefits x x

Checking Eligibility and Benefits in CareFirst Direct

CareFirst on Call
Benefit Accumulations (like maximums and deductibles) x x

Checking Eligibility and Benefits in CareFirst Direct

CareFirst on Call
Claims Status and Denial Reasons (line by line) x x

Checking Claim Status in CareFirst Direct

CareFirst on Call
Claim Numbers x x Checking Claim Status in CareFirst Direct

CareFirst on Call
Ability to submit Claims Inquiries x   Claims Inquiries in CareFirst Direct
View Remittances/NOPs (requires access from your Portal Admin) x   How to Read NOPs for Medical Providers

Electronic Remittance (835) for Medical Providers
View PCP Information (when available) x   Checking Eligibility and Benefits in CareFirst Direct
Obtain Transaction IDs  x x CareFirst on Call
Note: Transaction IDs are available within CareFirst Direct for all actions performed.
Receive Verification/Information via Fax   x CareFirst on Call
View Fee Schedules (requires access from your Portal Admin) x   Fee Schedules in CareFirst Direct

 

You can find additional training on our Learning and Engagement Center. On this site, you have access 24/7 to on-demand modules about CareFirst Direct, Claims and more. Visit carefirst.com/learning to access the training on your own time. In addition, you can access these Quick Reference Guides for CareFirst on Call (IVR) to assist with navigation – CareFirst on Call: Professional Providers and CareFirst on Call: Institutional Providers.

If you are still having trouble finding what you are looking for, check out our Looking For Support? webpage. This page gathers common requests in one place, so you can easily find what you are looking for. Visit carefirst.com/providersupport for more information.