CareFirst billing and credentialing
Billing and credentialing for CareFirst BlueCross BlueShield.
Working with CareFirst
CareFirst is the Blue plan for Maryland, Washington, DC and Northern Virginia, offering commercial, federal employee and Medicaid plans.
Plan types we bill:
- Commercial plans
- Federal Employee Program
- Medicaid in Maryland
Credentialing and enrollment
Credentialing uses your CAQH ProView profile, which must be complete and re-attested every 120 days.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
CareFirst provides its own provider portal for eligibility, claims and authorizations, and processes BlueCard claims in its area.
Denials we prevent with CareFirst
- Provider not credentialed or not linked to the group
- Out-of-area members not billed through BlueCard
- Missing prior authorization
- Coding and bundling edits under plan policy
- Late filing under the contract
Questions about CareFirst
Do you bill Federal Employee Program claims?
Yes. FEP claims follow their own benefit rules, and we bill them through CareFirst in its area.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with CareFirst claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.