Looking for Support?

We know you’re busy and want electronic tools to do business with CareFirst. This page compiles common requests from our healthcare delivery partners and shows you where to get the information you need.

We suggest that you bookmark this page since we will continue to add more helpful information over time.

For a comprehensive list to all your most important provider information, refer to our Provider Link List. For technical support, call the CareFirst Help Desk at (877) 526-8390.


Are You a Maryland Medicaid and/or DSNP Provider?

Are you a CareFirst Community Health Plan Maryland (CareFirst CHPMD) or Medicare Advantage DualPrime (DSNP) Provider? Access the websites below for information about Claims, Eligibility, Authorization Guidelines, Appeals & Grievances, Educational Resources and more for these lines of business:


Credentialing

Do you want to join our networks or check the status of a credentialing application?

We are actively recruiting healthcare delivery partners to support our growing membership. Check out our Professional Credentialing, Institutional/Ancillary Credentialing or Dental Credentialing pages for details on our processes, required documents and key points of contact. Our credentialing processes are rigorous to ensure we maintain exceptional networks for our members and subscribers. Therefore, please allow up to 120 days from receipt of completed application for a determination for Medical Providers and 60 days from receipt for Dental Providers.


Updating your Provider Data (Professional Providers)

Do you need to attest to or make changes to your practice data?

Medical Providers Keeping your information updated makes it easier for our members to find you and grow your business. Plus, it keeps you in compliance with both the Consolidated Appropriations Act (CAA) and your CareFirst contract. Refer to the Update Your Practice Info page for more details.

Dental Providers: Dental offices who need to change their file information may submit a Dental Change in Provider Information Form. It’s also available on CareFirst Direct, our online provider portal, post-login. Any change to a provider’s file must be received in writing.

Do you want to see how you are listed in our Provider Directory?

We have a quick tutorial on how to access and review your data in our Provider Directory.  Click here to review the step-by-step instructions. If after you have reviewed your information, you need to make an update, go to:


Provider Portal – CareFirst Direct Access

Need to register for our provider portal?

Maintaining an active account for our provider portal ("CareFirst Direct") is one of the best ways to be successful. To register, go here. If your practice already has active portal users, you may need to work through them for access.

For technical questions, contact our Help Desk at 1-877-526-8390.

We also have user guides to walk you through common transactions. Go to On Demand Training and navigate to the CareFirst Direct section. We recommend logging in at least once a month to avoid being locked out of your account or terminated.

I have an account, but my practice/facility does not have a portal administrator. How do we get one assigned?

If your practice/facility does not currently have an active Portal Administrator, contact the Help Desk at 877-526-8390 for assistance. This access is crucial to ensuring your practice/facility can approve user access requests, complete required user access reviews, set up new users and terminate user access as appropriate.


Eligibility, Benefits and Claims Status

Have a question about member eligibility, benefits, or claims status? 

Use our online tools for the fastest answer – they're available 24/7/365. The CareFirst Direct user guides walk through common transactions. You can even submit an inquiry online to learn more about a claim’s payment.


Claims Questions

Have a question about a claim’s denial or payment?

For inquiries that cannot be resolved on CareFirst Direct, call the Provider Service number on the back of the member’s ID card during business hours to speak to a customer service associate. Check out the quick reference guides below to learn more about our claims and service teams.


Fee Schedules

Need a copy of your fee schedule? Want to know what we pay for a particular code?

Good news — most practices can access their fee schedule online. We even have user guides to help walk you through it.

Note: Users must have ‘Fee Schedule’ access within the Provider Portal to view Fee Schedules (see user guide for more details)


Medical Policy

Want to know what we cover in our products?

To understand what we cover, you can view our medical policy. You can also verify if a patient is covered for a service by verifying their eligibility and benefits in CareFirst Direct.


Electronic Capabilities

Want to receive electronic remittance advice (ERA) or enroll in/make changes to electronic funds transfer (EFT) accounts?

Electronic funds transfer is the quickest, most secure way to get paid by CareFirst. Medical providers can even earn points in the relationship health portion of the CareFirst provider profile score for being enrolled in both ERA and EFT.

To get started, click on the appropriate link below:


Training and Resources

Looking for more training and resources on how to do business with CareFirst?

Check out our Learning and Engagement Center at carefirst.com/learning. We offer live webinar registration, on-demand modules and customized training curriculums for you or your staff. Don't see what you’re looking for? Submit a request to learning@carefirst.com.

That said, sometimes the easiest way to get a question answered is by browsing our online Provider Manuals:


Tax Form Requests

Need help obtaining a 1099 form?

Please reach out to our Accounts Payable area for assistance at 410-998-6750 or ap@carefirst.com.


Provider Quick Reference Guides

Need easy resources to help locate provider service numbers, utilize our interactive voice response system, CareFirst on Call, or information on how to read a Member ID card? Check out our Provider Quick Reference guides at carefirst.com/providerguides.


Participating Provider Escalated Issues

Are you a Participating Provider with an escalated issue you can't resolve?

If you’ve tried to resolve your issue using the resources above and still have questions, feel free to give us a call. As a reminder, you will have to wait for a response from us. However, we will do our best to get back to you in a few days.

Important Note for Non-Participating Providers: This mailbox is used by Participating Providers. If you are not currently participating with CareFirst, please contact the Provider Service number located on the back of the Member’s ID card for assistance.

Medical Providers 

We have a dedicated team here to help. You can leave a detailed voice message for Provider Relations at (410) 872-3512 or (833) 939-4107 Please include the following:

  • Reference and/or Ticket Numbers (from Provider Service and/or Helpdesk)
  • Your Name and Role,
  • Phone Number,
  • Practice Name,
  • NPI,
  • Tax ID,
  • Specialty,
  • Detailed explanation of the issue or request (and information on anything you've already tried to resolve your concern).

We monitor this mailbox regularly and will have a Provider Relations professional reach out within a few days.

Dental Participating Providers

Reach out to our Dental Provider Specialists for assistance.


Stay Connected – Sign up for CareFirst Communications

Want to stay connected with regular CareFirst communications?

Sign up for BlueLink (Medical Providers) or BlueImpressions (Dental Providers) to get the latest news delivered to your mailbox regularly. Multiple points of contact can be enrolled in our newsletters for each practice.

See our news archive here. Read past articles of our newsletter here.


Providers in Value-Based Arrangements

Have a question about your performance or want to refer a patient?

You have additional resources to help! Here is a contact listing for your Practice Consultants and Care Management team.

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