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Government Programs
Specialty topics and courses dedicated to our Government Programs healthcare delivery partners.
Featured Course
Need information on how to enter a prior authorization? We recommend Entering Authorization in the CareFirst Provider Portal. Learn about entering inpatient and outpatient authorizations, withdrawing authorizations and much more!
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Self-paced module | 15 minutes | All Medical CareFirst CHPMD and CareFirst Advantage DualPrime Providers
An overview of information providers need to orient themselves to CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst CHPMD) and CareFirst BlueCross BlueShield DualPrime (HMO-SNP) plans.
This course is comprised of three segments:
- Section 1: General Information
- Section 2: Administrative Processes
- Section 3: Programs and Services
Entering Authorizations in the CareFirst Provider Portal
Self-paced module | 15 minutes | All Medical CareFirst CHPMD and CareFirst Advantage DualPrime Providers
A step-by-step guide to entering prior authorizations via the CareFirst Provider Portal.
CareFirst Advantage DualPrime Special Needs Plan (SNP) - Model of Care
Self-paced Module | 15 minutes | All Advantage DualPrime Providers
This course will describe how CareFirst BlueCross BlueShield Advantage DualPrime and its contracted providers work together to successfully deliver the Special Needs Plan (SNP) Model of Care program.
CareFirst BlueCross BlueShield Individual Medicare Advantage (MA) (PPO) for Providers
Self-paced Module | 15 minutes | All Medical Providers
An overview of the CareFirst BlueCross BlueShield Individual Medicare Advantage (MA) (PPO) product offerings and navigating healthcare options for your Medicare Advantage patients.
- Individual Medicare Advantage PPO Plan overview
- How to Identify Member ID Cards
- How to Determine Which Networks You Participate In
- How to Verify Eligibility and Benefits
- Authorizations
- Claims, Appeals and Disputes