CareFirst CHPMD Members: Keep your info current. Keep yourself insured. Medicaid renewals won’t be automatic this year. Check in to make sure your contact information is up to date to receive important notices on any changes to your health insurance. To update your address, phone number or email, log in to your MHC online account. If you need assistance, call MHC at 1-855-642-8572.

CareFirst CHPMD Providers: Encourage your patients to update their information. Find out how you can help your patients renew their coverage here.

Forms

Click on the below form that best meets your needs.

Member PCP Change Form
Primary Care Provider Acceptance Form
Post Claims Adjudication Payment Dispute Form
Appeals and Grievance form
Maryland Prenatal Risk Assessment form
Credentialing Application
Preauthorization (General) Request Form
Preauthorization (Home Health and Rehab) Request Form
Preauthorization (Medical Injections) Request Form