Avoid Billing Errors with CareFirst Direct

March 03, 2015 - It is more important than ever to use CareFirst Direct to verify your patients' eligibility and benefits prior to rendering care - especially for specialists.

Why?

CareFirst is making additional care coordination programs and specialized care services available to your patients.

If you have patients in these programs, their costs (copayments, coinsurance, deductibles and visit limits) may be waived for certain services.

What does this mean for you?

If you bill for services that are waived, you will be required to provide your patients with a cash refund. To avoid unnecessary paperwork, always verify your patients' eligibility and benefits through CareFirst Direct.

How to check in to CareFirst Direct?

When viewing the eligibility/benefits screens in CareFirst Direct, you'll see the following messages:

If your patient's costs are waived:

Cost Share Waiver: CareFirst will waive costs for all in-Network Professional claims for covered services.

If your patient's costs are not waived:

Cost Share Waiver: Member may have costs associated for this program (copays, coinsurance, deductibles and limits).

What is CareFirst Direct?

CareFirst Direct is a free, convenient tool that gives you fast access to the information you need.