CommercialAdministrativeMedium impact
Payment Audits in Progress for Certain Claims
CareFirst BlueCross BlueShield·Reimbursement
Effective date
Jun 14, 2023
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield has partnered with EquiClaim to conduct payment audits on certain hospital and facility claims. Providers will receive audit requests starting in June 2023 and must submit requested documentation directly to EquiClaim within 30 days, not to CareFirst.
Action Required
Within 30 days of receiving audit requests: Submit all requested documentation directly to EquiClaim following letter instructions - DO NOT send to CareFirst. Within 60 days: Return signed audit agreement to EquiClaim. Billing team should establish workflow to handle EquiClaim audit requests and track response deadlines.