CareFirst Customer Care: Practical, Expert Guidance for Members, Employers, and Providers

How to Reach CareFirst Customer Care

For the fastest help, start at carefirst.com and use the secure “Log In” link to access your My Account dashboard. Digital self-service covers most needs: ID card download, benefits and deductible balances, claims/EOBs, PCP changes, referrals, and secure messaging with Customer Care. If you have more than one plan (for example, medical and dental), be sure to select the correct policy when reviewing benefits or sending a message.

Phone numbers vary by plan and are printed on the back of your CareFirst ID card. Use that number for plan-specific benefits, authorizations, and claims questions. Federal Employee Program (FEP) members can call the national FEP Blue help line at 800-411-BLUE (2583) and visit fepblue.org for dedicated resources. Members who use TTY or are hard of hearing can connect via 711 ( Telecommunications Relay Service) to reach any CareFirst line.

General corporate correspondence (not for claims or premium remittances) can be sent to: CareFirst BlueCross BlueShield, 10455 Mill Run Circle, Owings Mills, MD 21117. For privacy and speed, prefer secure messages in your online account rather than postal mail. Typical Member Services hours are business days during Eastern Time; consult the number on your ID card for the exact hours for your plan or line of business.

Access and Digital Tools That Save Time

My Account on carefirst.com is the hub for routine requests. You can check real-time accumulators (deductible, out-of-pocket maximum), view Explanation of Benefits (EOB) statements, submit certain claims, update coordination of benefits, and start an appeal or grievance. The portal also displays your plan documents (Summary of Benefits and Coverage, Certificate of Coverage) and networks to confirm whether a provider is in-network before you schedule care.

The CareFirst mobile app (iOS and Android) mirrors core portal functions and adds practical tools like digital ID cards and location-based provider search. If you authorize notifications, you’ll get alerts when a claim finishes processing or when CareFirst needs more information. For dependents, you can set up permission (HIPAA authorization) so a spouse or parent can speak with Customer Care on your behalf—a common step that avoids delays during claims or appeal calls.

Quick Solutions to Common Requests

Most issues resolve fastest if you gather specific information before contacting CareFirst: your member ID, claim number (if applicable), the date of service, and the provider’s name and NPI. For billing disputes, have both the provider’s invoice and the corresponding EOB ready. For benefit questions, note your plan year (calendar or contract year), as accumulators reset based on that schedule.

Claims and payments follow prompt-pay standards. As a rule of thumb, clean electronic claims typically process within about 30 days and paper claims within about 45 days, depending on regulatory requirements and whether additional information is needed. If a claim exceeds those windows, Customer Care can trace it and place a follow-up request with the claims team.

• Need an ID card quickly: Download a digital ID card instantly from the portal or app. If you need a physical card, request one and confirm your mailing address; delivery usually takes 5–10 business days.
• Confirm a provider is in-network: Use the Find a Doctor tool from your online account to filter by your network name (e.g., BluePreferred, BlueChoice, or BlueCard PPO). Screenshots of the search results help if you later need to dispute an out-of-network charge.
• Fix a claim billed under the wrong insurance: Update coordination of benefits online (primary/secondary) and ask Customer Care to reprocess the claim once your policy order is corrected.
• Submit an out-of-network claim: Upload a complete itemized bill with diagnosis codes (ICD-10), procedure codes (CPT/HCPCS), dates of service, and the provider’s tax ID. Keep copies; processing can take up to 45 days for paper submissions.
• Start an appeal: File within the deadline on your denial letter (commonly 180 days for internal appeals). Attach clinical notes, referral/authorization numbers, and any supporting literature your provider can supply.

Pharmacy, Mental Health, and Care Management

Pharmacy benefits for many commercial CareFirst plans are administered through a national pharmacy partner. Check the back of your ID card for the dedicated pharmacy member number and website; using your pharmacy portal lets you price medications, locate in-network pharmacies, and manage mail-order refills. Mail-order is often the lowest-cost option for 90-day maintenance supplies; compare pricing before refilling at retail.

Mental and behavioral health benefits are covered the same as other medical services under parity laws. Use the mental health or behavioral health number on your ID card for fast assistance finding an in-network therapist or psychiatrist with current availability. In a crisis, call or text 988 (24/7 nationwide Suicide & Crisis Lifeline) or use 988lifeline.org; for immediate danger, call 911.

If you have a complex condition or recent hospitalization, ask Customer Care about case management or care coordination programs. These programs can help schedule follow-ups, align benefits across multiple providers, and reduce out-of-pocket costs by steering you to high-value, in-network facilities.

Prior Authorization, Claims, and Appeals: What to Expect

Some services require prior authorization (PA)—common examples include advanced imaging (MRI/CT), certain specialty drugs, planned admissions, and select surgeries. Your provider usually initiates the PA. Standard PA decisions typically issue within 15 calendar days; urgent requests are expedited, commonly within 72 hours. Always ask for the PA reference number and verify that the approved dates and provider match your scheduled service.

After you receive care, you’ll get an Explanation of Benefits (EOB), not a bill, outlining the allowed amount, your share (copay, coinsurance, or deductible), and any remaining balance. Match the EOB to the provider’s invoice. If the provider billed a diagnosis or procedure code that led to a denial, ask them to review and, if appropriate, resubmit with corrected coding; then alert CareFirst to expect a corrected claim.

If you disagree with a denial, file an internal appeal by the deadline in your denial notice (commonly 180 days). Include clinical documentation and a letter from your provider explaining medical necessity. If the internal appeal is denied, you may have the right to an independent external review; the request window is usually 4 months from the final internal decision. Keep copies of all submissions and note tracking numbers and dates.

For Employers and Providers

Group administrators should designate a primary benefits contact with CareFirst and maintain up-to-date eligibility files. Use your employer portal to add or terminate members promptly; late terminations can create retroactive claims complications. If your group offers Health Savings Accounts (HSAs) or HRAs, align effective dates so members’ out-of-pocket expenses integrate correctly with their spending accounts.

Providers can verify eligibility/benefits and check claim status online via the CareFirst provider portal. For out-of-area members with an ID prefix not issued by CareFirst, use the BlueCard program routing on the member ID card and contact the home plan as indicated. Keep your practice’s demographics (address, panel status, NPIs) current to avoid directory inaccuracies and authorization misrouting.

• FEP members and providers: Use 800-411-BLUE (2583) and fepblue.org for benefits, prior authorization guidance, and claim inquiries specific to the Federal Employee Program.
• BlueCard provider line: For out-of-area Blue plans and eligibility assistance, providers can use the national BlueCard line at 800-676-BLUE to reach the appropriate home plan.
• Coordination of care: Include authorization numbers on claims, match service dates to approved spans, and attach operative or infusion notes when requested to prevent medical-necessity denials.

Escalations and Regulatory Contacts (MD, DC, VA)

If you’ve worked with Customer Care and a supervisor but still need help, ask for instructions to file a grievance or an appeal in writing. Keep a dated log of all calls, names, and case numbers. For urgent medical issues tied to an authorization or claim, clearly state that your situation is urgent to request an expedited review.

State regulators can assist when plan-level processes are exhausted or timelines are not met. File with the regulator in your state of residence or where the plan is issued. Include your denial letters, EOBs, and appeal decisions with your complaint.

Maryland Insurance Administration: 200 St. Paul Place, Suite 2700, Baltimore, MD 21202; consumer line 800-492-6116 or 410-468-2000; insurance.maryland.gov. District of Columbia Department of Insurance, Securities and Banking (DISB): 1050 First Street NE, Suite 801, Washington, DC 20002; 202-727-8000; disb.dc.gov. Virginia State Corporation Commission, Bureau of Insurance: Tyler Building, 1300 E. Main Street, Richmond, VA 23219; consumer services 804-371-9741 or 877-310-6560; scc.virginia.gov/pages/Insurance.

Bottom Line

Use the phone number on your CareFirst ID card for plan-specific help, and the online account for rapid self-service. Keep documentation organized, confirm in-network status and authorizations in advance, and know your appeal rights and timelines. These steps resolve most issues quickly and protect you from avoidable out-of-pocket costs.

Is BCBS 24 hour customer service?

Customer Care Representatives are available 24 hours a day, 7 days a week.

What is the phone number for CareFirst provider service?

410-872-3500
Please call CareFirst Provider Information and Credentialing at 410-872-3500 or 877-269-9593. You can also reach out to your local Blue plan.

How do I call CareFirst 24hr first help?

Call 800-535-9700 anytime, day or night.
The Nurse Advice Line provides support and guidance for any non-emergency situation. The service is personal, confidential and available at no cost.

Is CareFirst Blue Cross Blue Shield the same as Anthem?

Anthem is part of the Blue Cross Blue Shield group. Blue Cross Blue Shield is made up of independent companies. Anthem is one of these companies. Other Blue Cross Blue Shield brands include Highmark, Regence and CareFirst.