CommercialPrior AuthHigh impact
Utilization Management Flexibilities
CareFirst BlueCross BlueShield·Prior Authorization
Effective date
Jan 6, 2022
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is temporarily relaxing prior authorization requirements through February 15, 2022, including automatic 30-day admission approvals for qualifying hospitals, relaxed facility transfer requirements, and 6-month extensions for approved elective surgery authorizations that were postponed.
Action Required
Immediately through February 15, 2022: Billing team should notify CareFirst within 72 hours of emergency admissions and facility transfers. For qualifying facilities with formal processes for prioritizing time-sensitive admissions, contact CareFirst nurse or Provider Relations Representative to enable 30-day automatic authorization. For rescheduled elective surgeries with existing approvals, contact CareFirst Utilization Management at 866-773-2884 or via provider portal to update service dates to ensure proper claims processing.