How to Get Credentialed with CareFirst BlueCross BlueShield in District Of Columbia
Quick Overview
Timeline
60 - 120 days
CAQH
Required
Re-credentialing
Every 3 year(s)
Delegated
No
District Of Columbia-Specific Requirements
Step-by-Step Enrollment Process
Gather Required Documents
Collect all necessary credentials including your medical license, DEA certificate, malpractice insurance, NPI number, and any state-specific requirements for District Of Columbia.
Complete Your CAQH ProView Profile
CareFirst BlueCross BlueShield requires a current CAQH ProView profile. Create or update your profile at proview.caqh.org and attest within 120 days.
Submit Your Application
Submit your completed enrollment package to CareFirst BlueCross BlueShield.
Track & Follow Up
Credentialing typically takes 60-120 days. Monitor your application status and respond promptly to requests for additional information.
Free Consultation
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Required Documents Checklist
Board Certification
ConditionalRequired if board certified; highly recommended
CV/Resume
5-year work history minimum; gaps > 6 months must be explained
DEA License
ConditionalRequired if prescribing controlled substances
Malpractice Insurance
Medical Degree
Medical License
NPI Certificate
Professional Reference
3 peer references required
Enrollment Forms
CAQH ProView
Universal credentialing application used by most commercial and BCBS payers.
RequiredFree Tools for Your CareFirst BlueCross BlueShield Enrollment
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Key Credentialing Terms
- CAQH
- The Council for Affordable Quality Health Care, an organization that maintains a universal provider database (CAQH ProVi...
- Credentialing
- The process of verifying a healthcare provider's qualifications, training, licensure, and professional background to ens...
- Effective Date
- The date on which a provider's enrollment or network participation becomes active, allowing them to begin billing a paye...
- Fee Schedule
- A complete listing of fees and reimbursement rates that an insurance payer will pay for specific medical services and pr...
- HMO
- A Health Maintenance Organization is a managed care plan that typically requires members to choose a primary care physic...
- Network Status
- A provider's participation status with a specific insurance payer, indicating whether they are in-network (contracted) o...
- NPI
- The National Provider Identifier is a unique 10-digit identification number issued by CMS to healthcare providers, requi...
- PPO
- A Preferred Provider Organization is a managed care plan that offers a network of contracted providers at lower costs to...
Credentialing Checklist
Make sure you have everything ready before applying to CareFirst BlueCross BlueShield.
View Physician Credentialing Checklist →Contact Information
Provider Credentialing
National877-269-9593
Mon-Fri 8am-5pm
Provider Services
National877-269-9593
Claims & Billing
National877-269-9593
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Reviewed by the PayerReady Credentialing Team
Our credentialing specialists verify every article against current CMS regulations, NCQA standards, and payer-specific enrollment requirements. See our editorial process.