Provider Quick Reference Guide

Provider Quick Reference Guide

Products/ID Card Prefixes

Provider Service Phone #

BlueChoice--XIK, XIR, XIB, QXG, 8008425975 QXA, XIE, JHZ, XWZ, XIG, QXK

BluePreferred--XIL, XWV, JHJ, XII, JHI, XIQ, QXM, XIY, XIU

HealthyBlue--JHG, QXF, JHA, JHC, QXB, QXE, XIF, JHD, JHE, QXD, JHH, QXI, QXL, QXU, QXR, QXS, QXT, QXC, QXH

Indemnity--XIJ, XWY

The National Account Service 8772287268 Company (NASCO)

All prefixes are unique. CareFirst IDs have plan codes 080/580 and 190/690.

Federal Employee Program (FEP)

DC/Metropolitan Area 2024884900

R prefix

MD 8008545256

BlueCard Prefixes are unique

Medicare Advantage--MAC CareFirst IDs have plan code 193.

Eligibility 8006762583 Out-of-area claims 8772287268

855-290-5744 Fax: 410-605-2566

Where to Send Claims

Mail Administrator P.O. Box 14116 Lexington, KY 40512

Mail Administrator P.O. Box 14115 Lexington, KY 40512

DC/Metropolitan Area Mail Administrator P.O. Box 14113 Lexington, KY 40512 MD Mail Administrator P.O. Box 14113 Lexington, KY 40512 Send claims to your local plan: Mail Administrator P.O. Box 14116 Lexington, KY 40512 CareFirst BlueCross BlueShield Medicare Advantage P.O. Box 4495 Scranton, PA 18505

Where to Send Correspondence

Mail Administrator P.O. Box 14114 Lexington, KY 40512

Mail Administrator P.O. Box 14114 Lexington, KY 40512

DC/Metropolitan Area Mail Administrator P.O. Box 14112 Lexington, KY 40512 MD Mail Administrator P.O. Box 14111 Lexington, KY 40512 Mail Administrator P.O. Box 14114 Lexington, KY 40512

CareFirst BlueCross BlueShield Medicare Advantage P.O. Box 3236 Scranton, PA 18505

Resources

Contact Information and Phone #

General Assistance CareFirst Help Desk: 877-526-8390

Behavioral Health Credentialing

CareFirst: 8002457013

Professional

Mail Administrator P.O. Box 14763 Lexington, KY 40512

Phone: 8772699593 or 4108723500

Fax: 4108724107

Institutional/Ancillary

CareFirst BlueCross BlueShield 10455 Mill Run Circle Mail Stop CG51 Owings Mills, MD 21117

Phone: 410872-3526

Fax: 410-505-2765

Link to Website

credentialing

Resources

Contact Information and Phone #

Link to Website

Precert/Preauth

Pharmacy Lab

Medical: 8667732884

CVS Specialty Pharmacy:

CVS Pharmacy: 8555822038 8888770518

preauth

CVS Caremark: 8002413371

rx

LabCorp:** 1-888-LabCorp (522-2677)



Quest Diagnostics: 866-697-8378 (available to PPO members only)

**Note: BlueChoice members must use LabCorp.

Resource

Area

Contact Phone #

Other Party Liability

Large Group, Consumer Directed Healthcare (CDH), Administrative Services Only (ASO)

CareFirst (Small/Medium Group and Consumer Direct) NASCO (Large Groups, CDH, ASO/self-insured)

Workers Compensation/Subrogation FEP Workers Compensation/ Subrogation FEP Coordination of Benefits (COB)

866-285-2611 877-228-7268

443-471-5589 or 443-471-5585 800-854-5256

DC 202-680-7773 202-680-7777 202-680-7778 202-680-7779

MD 410-998-6845 410-998-6835 410-998-6840 410-998-6841

For additional online resources, view our Provider Link List, available at providermanualsandguides.

CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name ofTrusted Health Plan (District of Columbia), Inc. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BLUE CROSS?, BLUE SHIELD? and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

CUT6010-1E (10/20)

Notice of Nondiscrimination and Availability of Language Assistance Services

(UPDATED 8/5/19)

CareFirst BlueCross BlueShield, CareFirst BlueChoice, Inc., CareFirst Diversified Benefits and all of their corporate affiliates (CareFirst) comply with applicable federal civil rights laws and do not discriminate on the basis of race, color, national origin, age, disability or sex. CareFirst does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

CareFirst:

Provides free aid and services to people with disabilities to communicate effectively with us, such as: Qualified sign language interpreters Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provides free language services to people whose primary language is not English, such as: Qualified interpreters Information written in other languages

If you need these services, please call 855-258-6518.

If you believe CareFirst has failed to provide these services, or discriminated in another way, on the basis of race, color, national origin, age, disability or sex, you can file a grievance with our CareFirst Civil Rights Coordinator by mail, fax or email. If you need help filing a grievance, our CareFirst Civil Rights Coordinator is available to help you.

To file a grievance regarding a violation of federal civil rights, please contact the Civil Rights Coordinator as indicated below. Please do not send payments, claims issues, or other documentation to this office.

Civil Rights Coordinator, Corporate Office of Civil Rights

Mailing Address

P.O. Box 8894 Baltimore, Maryland 21224

Email Address

civilrightscoordinator@

Telephone Number Fax Number

410-528-7820 410-505-2011

You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights electronically through the Office for Civil Rights Complaint portal, available at or by mail or phone at:

U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at .

CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., The Dental Network and First Care, Inc. are independent licensees of the Blue Cross and Blue Shield Association. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). The Blue Cross? and Blue Shield? and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

Foreign Language Assistance

Attention (English): This notice contains information about your insurance coverage. It may contain key dates and you may need to take action by certain deadlines. You have the right to get this information and assistance in your language at no cost. Members should call the phone number on the back of their member identification card. All others may call 855-258-6518 and wait through the dialogue until prompted to push 0. When an agent answers, state the language you need and you will be connected to an interpreter.

(Amharic) - 855-258-6518 0

?d? Yor?b? (Yoruba) ?tt?l?ko: ?k?y?s? y?? n? ?w?f?n n?pa i ad?j?t?f? r. ? le n? ?wn d??t? p?t? o s? le n? l?ti gb? ?gb?s n? ?wn j gb?d?ke kan. O ni t l?ti gba ?w?f?n y?? ?ti ?r?nlw n? ?d? r lf. ?wn m-gb gbd pe nmb? f??n? t? w? ly?n k??d? ?d?nim wn. ?wn m?r?n le pe 855-258-6518 k? o s? d?r? n?pas ?j?r?r? t?t? a ? fi s f?n l?ti t 0. N?gb?t? aoj? kan b? d?h?n, s ?d? t? o f a ? s? so p m ?gbuf kan.

Ting Vit (Vietnamese) Ch? ?: Th?ng b?o n?y cha th?ng tin v phm vi bo him ca qu? v. Th?ng b?o c? th cha nhng ng?y quan trng v? qu? v cn h?nh ng trc mt s thi hn nht nh. Qu? v c? quyn nhn c th?ng tin n?y v? h tr bng ng?n ng ca qu? v ho?n to?n min ph?. C?c th?nh vi?n n?n gi s in thoi mt sau ca th nhn dng. Tt c nhng ngi kh?c c? th gi s 855-258-6518 v? ch ht cuc i thoi cho n khi c nhc nhn ph?m 0. Khi mt tng ?i vi?n tr li, h?y n?u r? ng?n ng qu? v cn v? qu? v s c kt ni vi mt th?ng dch vi?n.

Tagalog (Tagalog) Atensyon: Ang abisong ito ay naglalaman ng impormasyon tungkol sa nasasaklawan ng iyong insurance. Maaari itong maglaman ng mga pinakamahalagang petsa at maaaring kailangan mong gumawa ng aksyon ayon sa ilang deadline. May karapatan ka na makuha ang impormasyong ito at tulong sa iyong sariling wika nang walang gastos. Dapat tawagan ng mga Miyembro ang numero ng telepono na nasa likuran ng kanilang identification card. Ang lahat ng iba ay maaaring tumawag sa 855-258-6518 at maghintay hanggang sa dulo ng diyalogo hanggang sa diktahan na pindutin ang 0. Kapag sumagot ang ahente, sabihin ang wika na kailangan mo at ikokonekta ka sa isang interpreter.

Espa?ol (Spanish) Atenci?n: Este aviso contiene informaci?n sobre su cobertura de seguro. Es posible que incluya fechas clave y que usted tenga que realizar alguna acci?n antes de ciertas fechas l?mite. Usted tiene derecho a obtener esta informaci?n y asistencia en su idioma sin ning?n costo. Los asegurados deben llamar al n?mero de tel?fono que se encuentra al reverso de su tarjeta de identificaci?n. Todos los dem?s pueden llamar al 855-258-6518 y esperar la grabaci?n hasta que se les indique que deben presionar 0. Cuando un agente de seguros responda, indique el idioma que necesita y se le comunicar? con un int?rprete.

(Russian) ! . , . . , . 855-258-6518 , ?0?. , .

 (Hindi) :

-

855-258-6518 0

,

s -w?? (Bassa) To uu Cao! B nia k a ny e ke m gbo kpa o ni fu a-fa-tiin ny je dyi. B nia k ee we j e m ke wa m m ke nyu nyu hw we ea ke zi. m ni kpe m ke b nia k ke gbokpa-kpa m m dye e ni ii-wuu mu m ke se wii o p. Kpoo ny e m a f?n-na nia e waa I.D. kaa ein ny. Ny t sein m a na nia k: 855-258-6518, ke m m fo tee wa ke m gbo c m ke na ma 0 k dyi paain hw. ju ke ny o dyi m g juin, po wuu m m po dyi, ke ny o mu o niin ke ni wuu mu za.

(Bengali) : 855-258-6518 0

: )Urdu(

0 855-258-6518

. : )Farsi( . . . . 0 855-258-6518 .

: (Arabic) . .

. 0. 855-258-6518

.

(Traditional Chinese) 855-258-6518 0

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