XII

BCBS Prefix XII

CareFirst BlueCross BlueShield

Maryland/District of Columbia/Northern Virginia • Traditional Indemnity, Medicare Advantage, POS

Billing essentials

Provider phone
(800) 842-5975
Electronic payer ID
00580
Claims mailing address
10455 Mill Run Circle, P.O. Box 825, Owings Mills, MD 21117
Timely filing limit
180 daysCompare all plans
Prior authorization phone
(866) 773-2884

Coverage under prefix XII

Traditional Indemnity

This prefix includes traditional indemnity coverage. Indemnity plans are the oldest form of health insurance and offer maximum provider choice with no network restrictions. Members pay a percentage of charges after meeting their deductible. Reimbursement is based on reasonable and customary rates for the service area.

Medicare Advantage

Medicare Advantage (MA) coverage means this member receives their Medicare benefits through a private BCBS plan rather than through original Medicare. MA plans may have different payer IDs and claims addresses than the commercial plan. Check with the payer to confirm the correct submission details for Medicare Advantage claims.

POS

POS (Point of Service) plans combine features of HMO and PPO coverage. Members choose a primary care physician and can get referrals to see in-network specialists at lower cost, or self-refer to out-of-network providers at higher cost. Claims should include referral information when the member uses the in-network benefit level.

About CareFirst BlueCross BlueShield

Independent licensee of the Blue Cross Blue Shield Association serving Maryland, District of Columbia and Northern Virginia.