Continuity of Electronic 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) 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. Fortunately, CareFirst is also contracted with Availity for commercial, FEP, Medicare Advantage HMO and Medicare Advantage PPO and there is no disruption to claims submitted through Availity for these lines of business.
For continuity of electronic claims submission, CareFirst recommends providers 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.
As a reminder, providers can use CareFirst Direct to check Member eligibility and benefits or to see a list of recent payments and remittances for these lines of business.
For CareFirst Community Partners, Inc. (Medicaid) and CareFirst Advantage DSNP, Inc. (DSNP) Members, CareFirst’s Information Technology teams are working to rapidly connect services for these Members. Providers seeking to confirm Members’ coverage for these products can access this information via MyHealthPortal or call 410-779-9359 or 800-730-8543.
CareFirst’s team is working diligently to ensure a smooth transition and minimize service disruptions, though some temporary adjustments may occur during this period. We appreciate your patience as we continue to navigate this situation.
If you have questions, please contact Provider Service using the number on the back of the member’s ID card.