CommercialAdministrativeMedium impact
CareFirst CHPMD Providers – New Electronic Medication Prior Authorization Submission Process Effective September 1, 2026
CareFirst BlueCross BlueShield·Prior Authorization
Effective date
Sep 1, 2026
We identified it
Jul 17, 2026
Summary
CareFirst CHPMD is launching an electronic medication prior authorization submission process through their provider portal (CareFirst Direct), which integrates with the Novologix system. Beginning September 1, 2026, providers must transition from phone/fax submissions to electronic submission to access streamlined processing and faster turnaround times.
Action Required
By August 18, 2026: Billing and clinical staff must complete training on the new electronic medication prior authorization process. Register for and attend at least one live webinar (dates available 8/18-9/10/26) or complete the on-demand 'How to Enter Medication Prior Authorizations' course through the Learning and Engagement Center. By September 1, 2026: Ensure all staff submitting medication prior authorizations for CareFirst CHPMD members are registered and able to access the CareFirst Provider Portal (CareFirst Direct). Update internal workflows to route all medication prior authorization requests through the electronic Novologix system instead of phone or fax. Verify access to the 'Prior Authorizations' or 'Prior Auth/Notifications' tile and the 'Medications' section. Reference the list of medications requiring prior authorization available in the policy resources. Failure to transition to electronic submission may result in delayed processing and claim denials.