Direct Electronic Claim Submission

CareFirst and CareFirst BlueChoice are offering a FREE way to submit claims electronically. To be eligible for direct claim submission, you must participate with at least one CareFirst network or the CareFirst BlueChoice network, submit only paper claims, and send less than 250 paper claims per month.

This Web-based program is very easy-to-use. Users simply enter claims into the familiar CMS1500 and UB92 forms and submit them directly to CareFirst and CareFirst BlueChoice. This program also builds a patient database and can pre-populate demographic information to reduce your entry time for patient information.

Benefits:

• It's FREE! The CareFirst and CareFirst BlueChoice direct claim submission feature is free to eligible providers.
• Eliminates incomplete submissions. All HIPAA-required fields are highlighted. Also, you are immediately notified if you submit incorrect information, such as incomplete provider or member numbers, partial diagnoses codes, and missing date of onset.
• Saves time. Office staff won't have to spend time preparing and mailing paper documents, or researching and resending claims that are returned due to incomplete or inaccurate information.
• Saves money. The need for postage and paper claim forms is eliminated.
• Faster processing. Without the delays of regular mail, your claims will get processed faster.

Getting Started:

Registering for direct claim submission is done in two parts:

1. First, you must register with CareFirst Direct, our eligibility and claim status tool. You will receive your login information via e-mail in a few minutes.
2. To register for the free direct claim submission feature, please print the enrollment form (77KB, 2 pgs.), complete it and fax it to 410-505-2492. You will be notified within 5 business days with your login information. At that time, you will also be able to register for training.

If you have any questions about direct electronic submission, or your login information, please call our eClaims Service Line at 410-998-4599.

Claims software powered by PayerpathTM.