CareFirst BCBS at a glance
| Legal name | CareFirst BlueCross BlueShield |
|---|---|
| Also known as | CareFirst, CareFirst BlueChoice, CareFirst BCBS MD |
| Category | BCBS affiliate |
| Parent organization | CareFirst, Inc. |
| Claims payer ID | 00580 — registry reference; verify the member product, transaction and clearinghouse |
| Eligibility (270/271) payer ID | 00580 — registry reference; verify the member product, transaction and clearinghouse |
| ERA (835) payer ID | 00580 — registry reference; verify the member product, transaction and clearinghouse |
| NAIC company code | Not established in this registry |
| States covered | Maryland, District of Columbia, Virginia |
| Members covered | ~3.5 million members |
| Provider resource entry point | https://provider.carefirst.com |
| Provider phone | Plan-specific |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for CareFirst BCBS
CareFirst's cited provider manual uses 365 days from service and, for inpatient institutional claims, from discharge. Timely-filing reconsideration is a separate six-calendar-month period after the rejection notice. Confirm the member product and applicable manual rather than apply this to every CareFirst affiliate.
| Submission type | Window |
|---|---|
| Initial claim reference | 365 days; inpatient institutional claims from discharge |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for CareFirst BCBS. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: CareFirst BCBS provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with CareFirst BCBS
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify CareFirst BCBS electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for CareFirst BCBS. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for CareFirst BCBS
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient CareFirst BCBS volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | 00580 — registry reference; verify the member product, transaction and clearinghouse |
| 270 / 271 eligibility | Listed in registry; verify current scope | 00580 — registry reference; verify the member product, transaction and clearinghouse |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 00580 — registry reference; verify the member product, transaction and clearinghouse |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
provider_phone
Source comparison: 2026-09-18
866-773-2884 is commercial medical precertification/prior authorization, not a universal claims/provider-service line. The guide lists different product contacts; remove the mislabeled generic phone and metadata claim.
Primary source for provider_phonetimely_filing_days, filing_rule, electronic_claims_supported
Source comparison: 2026-09-18
The chapter states 365 days from service, or discharge for inpatient institutional care, and separates six-calendar-month timely-filing reconsiderations. It lists 837/835/270 channels but does not validate every stored ID or X12 278.
Primary source for timely_filing_days, filing_rule, electronic_claims_supported
Not checked in this pass: All fields outside the specifically scoped findings, including legal-entity/NAIC identifiers, current enrollment and geographic coverage; Product-complete initial, corrected, secondary and appeal rules; applicable contracts and exceptions; Transaction-specific payer IDs, ERA enrollment and X12 278 unless explicitly established above; Prior-authorization code samples and current clinical criteria; QuickIntell capability/outcome claims and historical DataForSEO demand values; Accountable whole-record editorial approval (not supplied).
State coverage
CareFirst BCBS operates in the following states. Each link opens state-level Medicaid program details, dominant commercial payers, and state-specific RCM regulations.
Evaluate QuickIntell workflow fit for CareFirst BCBS
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for CareFirst BCBS; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for CareFirst BCBS; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for CareFirst BCBS before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about CareFirst BCBS
Where is the CareFirst BCBS provider portal?
Use https://provider.carefirst.com as a starting point for CareFirst BCBS provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for CareFirst BCBS?
CareFirst's cited provider manual uses 365 days from service and, for inpatient institutional claims, from discharge. Timely-filing reconsideration is a separate six-calendar-month period after the rejection notice. Confirm the member product and applicable manual rather than apply this to every CareFirst affiliate.
What is the CareFirst BCBS payer ID?
Claims: 00580 — registry reference; verify the member product, transaction and clearinghouse. Eligibility (270/271): 00580 — registry reference; verify the member product, transaction and clearinghouse. ERA (835): 00580 — registry reference; verify the member product, transaction and clearinghouse. Do not substitute a claims ID for an unverified transaction ID. Check current source findings and the member ID card before submitting.
Does CareFirst BCBS accept electronic claims?
Verify CareFirst BCBS electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a CareFirst BCBS denial?
This registry has not established a payer-specific appeal ladder for CareFirst BCBS. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do CareFirst BCBS prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
How do providers contact CareFirst BCBS?
This registry has not established one provider phone number for CareFirst BCBS. 1-866-773-2884 is commercial medical precertification/prior authorization, not general provider claims support. Select the product-specific provider-service line in the CareFirst quick reference guide. Use https://provider.carefirst.com as a starting point for CareFirst BCBS provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
For revenue-cycle teams
Connect payer lookups to your revenue-cycle workflow
Do staff repeatedly move between payer references, eligibility checks, claim status and remittance follow-up?
- Keep this payer's official reference available to the team.
- Identify one repeated administrative task and measure its handling time.
- Evaluate the required access, exceptions and reviewer handoff before expanding automation.
CareFirst BCBS is an operational reference. Payer decisions remain with the payer. Confirm plan coverage, system access and supported actions during a scoped evaluation.
Download the illustrative workflow worksheet (PDF) · Explore the AI RCM evaluation toolkit · Model the workload and costs
Automate workflows around CareFirst BCBS requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against CareFirst BCBS's current published documents before submission. CPT® is a registered trademark of the American Medical Association.