Who to Call:

Medical and Hospital Services

• Part C Member Services and Prior Authorizations:
  410-779-9932 or toll-free at 1-844-386-6762; TTY: 711
  October 1 - March 31 | 8 am - 8 pm EST | 7 days a week
  April 1 - September 30 | 8 am - 8 pm EST | Monday – Friday
   
• Behavioral Health (Carelon Behavioral Health):
  1-844-470-6334; TTY: 711
  24 hours a day, 7 days a week
   
• Vision (Superior Vision):
  1-844-475-6334; TTY: 711
  8am-8pm EST, Monday through Friday
   
• Dental (DentaQuest):
  1-844-474-6334; TTY: 711
  8am-8pm EST, Monday through Friday
   
• Routine Transportation:
  1-844-476-6334; TTY: 711
  8am-8pm EST, 7 days a week, October 1 through March 31 and Monday through Friday, April 1 through September 30
   
• Over-The-Counter Rx and Products:
  1-844-479-6334; TTY: 711
  8am-9pm EST, Monday-Friday
   
• Routine Hearing Exams and Hearing Aids
  1-877-438-9544; TTY: 711
  8 AM to 8 PM, EST, Monday-Friday
   
• All Plan Members:
  Please call CareFirst Medicare Advantage prior to all non-emergency inpatient admissions.

Prescription Drug Services

• Part D Member Services:
  1-844-786-6762; TTY: 711
  
  Member Services
  PO Box 915
  Owings Mills, MD  21117
   
• Requests for Prior Authorizations and Exceptions:
  1-855-344-0930; TTY: 711
   
• Pharmacy Help Desk (For Pharmacy Use Only):
  1-866-693-4620

Where to Write:

Member Services
PO Box 915
Owings Mills, MD 21117

Where to Send Premium Billing Forms:

Electronic Fund Transfer (EFT) Forms:
Attention Premium Billing
CareFirst BlueCross BlueShield Medicare Advantage
PO Box 915
Owings Mills, MD  21117

Social Security Administration/Railroad
Retirement Board Deduction Forms:
Attention:  Enrollment Department
CareFirst BlueCross BlueShield Medicare Advantage
PO Box 915
Owings Mills, MD  21117

Where to Submit Claims:

Medical and Hospital Claims
Providers:  Please submit your claims electronically (preferred method) via Electronic Data Interchange (EDI).  The payor ID for our Clearinghouse, Change Healthcare (formerly Emdeon) is 45282.  

Providers can obtain additional information about submitting claims through Change Healthcare by calling 866-506-2830 or visiting the website at http://www.changehealthcare.com. Any paper claims should be submitted to:

CareFirst BlueCross BlueShield Medicare Advantage
PO Box 9208
Canton, MA  02021

Members:  Please submit your claims for reimbursement to:

CareFirst BlueCross BlueShield Medicare Advantage
Claims Reimbursement
PO Box 915
Owings Mills, MD  21117

Behavioral Health Claims
CareFirst BlueCross BlueShield Medicare Advantage
c/o Carelon Behavioral Health
P.O. Box 1850
Hicksville, NY 11802-1850

Part D Drug Claims
CareFirst BlueCross BlueShield Medicare Advantage
c/o CVS Caremark
P.O. Box 52066
Phoenix, AZ  85072-2066

Where to Submit Appeals and Grievances

Grievances:

Grievances for Medical Care:

CALL: 410-779-9932 or toll-free 1-844-386-6762 (TTY users: 711)

            8 AM to 8 PM, 7 days a week from October 1 to March 31.
            8 AM to 8 PM, Monday – Friday from April 1 to September 30

Voice mail is available after business hours to leave messages

FAX: 1-844-405-2158

WRITE: CareFirst BlueCross BlueShield Medicare Advantage
              Attention: Appeals & Grievances Department
              P.O. Box 915
              Owings Mills, MD 21117

Grievances for Part D Prescription Drugs:

CALL: 1-844-786-6762 (TTY users: 711)

FAX: 1-855-633-7673

WRITE: Grievance Department
              P.O. Box 30016
              Pittsburgh, PA 15222-0330

Appeals:

Important Note:  Requests for “Expedited” or “Fast” Appeals may be made verbally; however, all Standard Appeals must be made in writing.

Appeals for Medical Care:

CALL: 410-779-9932 or toll-free 1-844-386-6762 (TTY users: 711)

            8 AM to 8 PM, 7 days a week from October 1 to March 31
            8 AM to 8 PM, Monday – Friday from April 1 to September 30
            Voice mail is available after business hours to leave messages

FAX: 1-844-405-2158

WRITE: CareFirst BlueCross BlueShield Medicare Advantage
              Attention: Appeals & Grievances Department
              P.O. Box 915
              Owings Mills, MD 21117

Appeals for Part D Prescription Drugs:

CALL: 1-844-786-6762 (TTY users: 711)

FAX: 1-855-633-7673

WRITE: CVS Caremark Coverage Determinations/Exceptions
              P.O. Box 52000
              Phoenix, AZ 85072-2000