CareFirst General Information Manual

Welcome

Welcome to CareFirst BlueCross BlueShield (CareFirst) and CareFirst BlueChoice (BlueChoice). Your participation in one or all of our networks means that you have access to thousands of local and national employers and their employees. Our member's have access to state-of-the-art facilities, some of the best physician and provider care in the country and medically proven advanced technology.

This manual gives you the information you need to service CareFirst and CareFirst BlueChoice members and to do business with us:

• Specific requirements of an employer's health benefits are varied and may differ from the general procedures outlined in this manual.
• If we make any procedural changes in our ongoing efforts to improve our service to you, we will update the information in this manual and notify you via BlueLink, our bi-monthly administrative newsletter.

If you have any questions or would like additional information about CareFirst, please call Provider Services at 202-479-6560 or 800-842-5975.

Our Mission

CareFirst and CareFirst BlueChoice shall be the leading regional health care company recognized for comprehensive portfolio of high-quality, innovative products and administrative services. Our purpose is to provide the best value to our customers in partnership with the health care community and in an environment which promotes respect, fairness and opportunity for our associates.

Philosophy of Care

We represent a philosophy of health care that emphasizes active partnerships between patients and their physicians. We believe that comprehensive health care is best provided by networks of health care professionals who are willing to be held accountable for the quality of their services and the satisfaction of their patients. We are committed to high standards of quality and professional ethics and the principle that patients come first.

We believe that patients should have the right care, at the right time and in the right setting. This includes comprehensive care for acute and chronic illness, as well as preventive care-- in the hospital, at the doctor's office and at home.

We believe that all health care professionals should be held accountable for the quality of the services they provide and for the satisfaction of their patients. We believe that members should have a choice within their health plans of physicians who meet high standards of professional training and experience. That informed choice and the freedom to change physicians are essential to building active partnerships between members and doctors.

We believe that health care decisions should be the shared responsibility of members, their families and health care professionals, and we encourage physicians to share information with members on their healthy status, medical conditions and treatment options.

We believe that consumers have a right to information about health plans and how they work. We believe that working with people to keep them healthy is as important as making them well.

We value prevention as a key component of comprehensive care, reducing the risks of illness and helping to treat small problems before they can become more severe. We believe that access to affordable, comprehensive care gives consumers the value they expect and contributes to the peace of mind that is essential to good health.

Adapted from the American Association of Health Plans (AAHP)