Member Eligibility Is Not Determined by PCP Name on ID Card
This reminder is intended for participating CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst CHPMD) and CareFirst BlueCross BlueShield Advantage DualPrime (HMO-SNP) providers and office staff. Please share with your scheduling, front-desk, and billing teams to help ensure members are not delayed or denied care due to the Primary Care Physician (PCP) information shown on ID cards.
PCP information printed on the member ID card may change and may not reflect the member’s current PCP assignment. The ID card should not be used to verify eligibility. Members should not be turned away based on the PCP name (or absence of a PCP name) on the ID card.
Important Reminders:
- PCP information on the member ID card may change frequently.
- Do not use the member ID card to determine eligibility.
- Do not turn members away based solely on the PCP name (or lack of PCP name) shown on the ID card.
Verifying Member Eligibility
Please access the CareFirst Provider Portal (CareFirst Direct) to verify eligibility and benefits for CareFirst CHPMD and DualPrime members. If the member is eligible on the date of service and the PCP participates with CareFirst CHPMD and DualPrime, the PCP may see the CareFirst member.
For additional information, please access the CareFirst CHPMD Provider Manual for Medicaid members or the CareFirst Provider Manual for Medicare members.
Thank you for your continued partnership and for helping to ensure CareFirst members have timely access to care.