CareFirst CHPMD & DSNP Continuity of Claims
CareFirst BlueCross BlueShield (CareFirst) remains committed to maintaining operations with providers and patients, striving to offer uninterrupted access to healthcare. Following the cybersecurity incident Change Healthcare reported on Wednesday, February 21, 2024, CareFirst took immediate measures, severing network connections with Change Healthcare to prevent any potential further risk to our members.
CareFirst ceased transacting business (eligibility transactions, accepting claims, managing provider payments, providing post-adjudication claims files and eligibility and benefits files) from Change Healthcare effective Wednesday, February 21, 2024. CareFirst does not know when Change Healthcare will be able to securely return to service; therefore, we encourage providers using Change Healthcare for claims submission to utilize other EDI vendors.
We are happy to announce that we are now accepting electronic claims through Availity for our CareFirst Community Health Plan Maryland (CareFirst CHPMD) and CareFirst Advantage DSNP, Inc. (DSNP) products.
For continuity of electronic claims submission, CareFirst recommends providers that were directly contracted with Change Healthcare for medical claims submission transition to Availity. The Availity connection is available now. Please find resources to support registering with Availity here: Availity Essentials Portal Registration.
If you use another EDI vendor who uses Change Healthcare as an intermediary for medical claims submission, we recommend you work with your vendor to reroute medical claims through Availity. Any medical claims submitted to CareFirst using or passing through Change Healthcare since February 21 for the products mentioned above should be resubmitted to CareFirst once connection to Availity has been established.
Providers who are registered to receive electronic remittance advice (ERA) through Availity will receive them going forward for claims sent through Availity. We are unable to provide ERAs for paid claims previously sent through Change Healthcare due to their outage.
Sending claims electronically is preferred and is your fastest path to payment.
To confirm coverage for CareFirst CHPMD and DSNP Members, please use MyHealthPortal or call 410-779-9359 or 800-730-8543.
For general updates for our CareFirst CHPMD and DSNP networks, including the latest claims submission guidance, providers are encouraged to attend our upcoming quarterly webinars on March 19 and 21. The registration link is available here: Webinars | CareFirst BlueCross BlueShield
We appreciate your patience as we continue to navigate this situation.