![]() 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. Consistent with 42 CFR 447.45, providers shall submit all claims to DMAS no later than 12 months from the date of service for which the provider requests. are independent licensees of the Blue Cross and Blue Shield Association. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc., CareFirst Advantage PPO, Inc., CareFirst Advantage DSNP, Inc., CareFirst Community Partners, Inc., CareFirst BlueCross BlueShield Community Health Plan District of Columbia, CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. of Maryland (used in VA by: First Care, Inc.). In Virginia, CareFirst MedPlus is the business name of First Care, Inc. In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. CareFirst BlueCross BlueShield Community Health Plan Maryland is the business name of CareFirst Community Partners, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO, Inc. and Group Hospitalization and Medical Services, Inc. Serving Maryland, the District of Columbia, and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. Click the link to sign-up for a date and time convenient for you. The Center for Provider Education and Training has scheduled numerous opportunities for you and your staff to become more familiar with this process. Where can you get more information on corrected claims submission? Claim filing If the member receives covered services from a contracting provider, a claim will be filed on their behalf by the provider. We urge you to submit all claims electronically however, if you do not have electronic claims submission capabilities, you can submit them on paper with 'Corrected Claim' written at the top of the claim form.įor electronic and paper claims submission, please allow 30 days for processing prior to checking your claims status on CareFirst Direct or the CareFirst on Call. A value of '7' in Loop 2300, Segment CLM05-3.Professional and Institutional Providers claims should include: Institutional providers should submit claims in the HIPAA transaction 837I.Professional providers should submit claims in the HIPAA transaction 837P.Do not submit a Provider Inquiry Resolution Form (PIRF) with a corrected claim.Ĭorrected claims should be submitted electronically to save time, money and help expedite claims processing - here's how: A corrected claim is not an inquiry or appeal. Electronic data interchange (EDI) is a powerful tool for increasing office productivity and improving. A corrected claim is a replacement of a previously submitted claim (e.g., changes or corrections to charges, clinical or procedure codes, dates of service, member information, etc.).
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