Carefirst Credentialing Services for your Independent Practice

Become a part of the region’s largest provider network. More than 90% of the region’s most dedicated health care providers now serve 3.3 million members in Maryland, Washington, D.C., and Northern Virginia.Professional providers may join our Blue Choice and/or Regional Participating Preferred Networks (RPN). The Council for Affordable Quality Healthcare (CAQH) ProView® is the quickest way to apply.All providers in the same practice must engage in the same provider networks to avoid confusion and unanticipated out-of-pocket charges for members.

On request, providers have the right to evaluate the information used in credentialing decisions, correct incorrect information, and obtain the status of the credentialing process.

Our Specialist will assist you in obtaining your credentials as soon as possible

We will review your educational history, career experience, credentials, and registration to practice in the healthcare industry during the credentialing process. Throughout the credentialing process, we will monitor your progress to determine your education, training, credentials, and registration to practice in a health care setting. We will examine all of your documents to ensure that you have been certified by one of the world’s most prominent healthcare providers. As a team, we are devoted to long-term growth. We will help you obtain the services you desire. This is how we show our appreciation to our customers and our commitment to providing great customer service.

How to Apply?

Providers that use CAQH ProView® to self-report credentialing information avoid having to fill out multiple, lengthy paper forms. As a general guideline, the following procedures can be taken:

• Sign up for CAQH ProView®.

• Get a CAQH ID.

• Complete and sign your profile

• Please upload the necessary documentation.

• CAQH ProView authorization settings should be saved to match the intended organization access. If you prefer to evaluate each payer’s request separately, please call CareFirst at 410-872-3500 or our toll-free number, 877-269-9593, to be added to the CAQH roster before commencing the Questionnaire.

Now that you’ve completed these steps, you can use our CareFirst system to automate your CAQH credentialing information. After you have gotten your CAQH identification number, attested to your profile, and uploaded all relevant evidence, simply complete the CareFirst Questionnaire.

CAQH Universal Credentialing

Three Benefits of Using CAQH ProView

Comply with reporting requirements

You can quickly self-report data required by health plans, hospitals, and other organizations when you use CAQH’s proView service.

• To credential with numerous insurers, only enter your information once.

• Eliminate or decrease duplicative paperwork.

Please update your information.

• If your information changes, you can rapidly update it online.

• Attestation takes minutes and should be done every 120 days. -Updated information is available to any organizations you have allowed.

Comply with re-credentialing requirements

Every three years, CareFirst requires clinicians to complete a re-credentialing process.

Re-credentialing:

Provider System retrieves provider data when recredentialing is due and loads into Provider Database. System processes will be integrated into existing workflows to drive data gathering.

Carefirst Phone Number

Who do I call if I have additional questions regarding credentialing and participation?
Answer: Call CareFirst Provider Information and Credentialing at 410-872-3500 or 877-269-9593.

Carefirst Enrollment Email

Send an email here privacy.office@carefirst.com. They’ll furnish everything coming out of your mind.

Carefirst Enrollment Form

Read here and fill it correctly: In this way they’ll verify all your details and on constant basis notify you about your o-going procedures and progress respectively. Here you’ll find enrollment form:
https://www.caqh.org/sites/default/files/solutions/proview/guide/PR-QuickRef.pdf

House of Outsourcing Billing Services

House of Outsourcing is an end-to-end revenue cycle management company provides medical billing services to more than 30 specialties. House of Outsourcing proficient staff handle your entire interventional radiology medical billing operation, from claim creation, accurate claim submission, on time follow up, denial management, appeals, payment posting, reporting as well as consistently guiding practice staff to get you paid 20% more and 50% faster. House of Outsourcing team uses A.I based practice management software to submit billing claims, tracks claims, reporting, scheduling, and patient notifications.