CareFirst Platform Migration Update
CareFirst BlueCross BlueShield (CareFirst) is in the final stages of a major platform upgrade that supports enrollment, eligibility and benefit information, and claims processing. We recognize the administrative impact this transition has had on provider offices and are sharing an update on what’s been completed and what to expect next.
Platform migration update
This platform transition is part of a multi-year initiative to improve system stability and operational reliability. As we finalize this work, we are focused on the following actions:
- System stabilization and monitoring: Dedicated teams continue to monitor platform performance and address issues as they are identified.
- Increased support capacity: Additional staffing and operational oversight are in place to help reduce call wait times.
- Improved benefit visibility: Benefit information is being aligned across systems to improve accuracy and reduce the need for manual verification.
- Claims processing: Claims continue to process and pay during the transition. If you have confirmation that an electronic claim was accepted by CareFirst, do not resubmit the claim, as resubmissions may delay processing. We are working though an increased inventory of claims.
Member access to care
Member benefits remain active. Providers should continue rendering covered services in accordance with their CareFirst agreement. At the time of service, collect only the member responsibility amounts, such as applicable copays or coinsurance.
Please proceed with medically necessary emergency care in accordance with policy. Emergent or urgent services that, if delayed, would cause immediate harm to the patient do not require prior authorization.
Thank you for the care you provide to our members.