Submitting a Claim

Use this information to submit claims to CareFirst CHPDC

All claims for services rendered must be submitted within 365 days from the date of service or discharge date for inpatient admissions. Claims submitted by practitioners must be billed on CMS-1500 forms.

When submitting a claim include the following information:

• Enrollee/Patients name and identification number
• Enrollee’s date of birth and address
• Diagnosis code(s)
• CPT or Revenue Codes
• Date(s) of service
• Place of service codes
• Charges (per line and total)
• Practitioner's federal tax identification number
• Practitioner's name
• Practitioner's PIN number and group number as applicable
• National Provider Identifier (NPI)
• Vendor name and billing address
• Name and address of facility where services were rendered
• Signature

Electronic claims may be submitted as follows:

Starting August 1, 2013 CareFirst CHPD will accept claims electronically through Change Health Care ( Formerly Emdeon) - Payor ID: L0230 and will have electronic remittance/ direct deposit capability. All clean claims submitted in a timely manner will be paid within 30 days in accordance with the provisions of the DC Prompt Payment Act of 2002.