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  • MEMBERS

    Member Overview

    Explore everything your health plan has to offer—learn more about your coverage, find helpful resources and connect with tools that can guide you.

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  • PROVIDERS

    Provider Overview

    Explore resources, information and tools to help make doing business with CareFirst Community Health Plan Maryland easier.

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    • Provider Overview
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  • CONTACT US

Forms & Guides

Click on a form or guide below that best meets your needs.

 
 
  • Provider Manual (PDF)
  • Member PCP Change Form (PDF)
  • Primary Care Provider Acceptance Form (PDF)
  • Post Claims Adjudication Payment Dispute Form (PDF)
  • Appeals and Grievance form (PDF)
  • Maryland Prenatal Risk Assessment form (PDF)
  • Credentialing Application (PDF)
  • Preauthorization (General) Request Form (PDF)
  • Preauthorization (Home Health and Rehab) Request Form (PDF)
  • Preauthorization (Medical Injections) Request Form (PDF)
  • Provider Referral Form (PDF)
  • NICU Authorization Form (PDF)

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HealthChoice is a Program of the Maryland Department of Health.

Serving Maryland, CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. an independent licensee 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.


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