Carefirst member portal

BlueDental Preferred and Individual Select Preferred Members. Mail a check or money order and invoice stub to: Payment Administrator PO Box 70250 Philadelphia, PA 19176-0250. Make the check or money order payable to: CareFirst BlueCross BlueShield; Individual Select Dental HMO Members. Mail a check or money order and invoice stub …

Carefirst member portal. Once registered, follow these steps to go paperless. In My Account, click your name in the top right corner and select Communication Preferences from the drop-down menu. Select Edit, located next to the Electronic Communication option. Check the Email box in the Explanation of Benefits (EOB) row and save your changes. Go Paperless.

Account Login. Access to this system is only allowed for authorized users. Our login process better protects the privacy and security of your personal information. ... Carefirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc., an ...

CareFirst Administrators (CFA) is the only third-party administrator in Maryland, D.C. and Northern Virginia providing flexibility and superior service, through the most trusted name in health care—locally through CareFirst BlueCross BlueShield, and nationally through the Blue Cross Blue Shield Association.Serving Maryland, the District of Columbia, and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO ...Offered through Carelon Medical Benefits Management. (Formerly AIM Specialty Health) Provider portal. Submit a new case for prior authorization, or check on an existing one. Sign in. Clinical guidelines and pathways. Access the evidence-based criteria used in our review process. Visit.Contact CareFirst Medicare Supplement MedPlus Member Services, at 800-722-2235 8 a.m.-6 p.m., ET, Monday through Friday. Shop for a Plan Find the Medicare plan that's right for you.CareFirst members receive a $100 monthly allowance in calendar year 2024. Once activated and attested to a qualifying condition, the $100 will be loaded on the card by the first of the following month and continue until the end of the year. ... Member Portal: dualprime.nationsbenefits.com. FAQ: Flex Benefit (OTC Mail Order, Groceries, and ...

Member ID (also called a subscriber number or patient ID)—the number providers need to verify coverage. 2. Group —the number identifies your employer plan; if you purchase health insurance through a Marketplace/Exchange, your card may not have a group number. 3. Plan identifier & PCP name —your plan and primary care provider’s name ... A new patient-centric, virtual-first primary care practice. Compassionate care for over 100 conditions through an easy-to-use app. 24/7/365. CloseKnit's care teams offer preventative and urgent care, behavioral and mental health, chronic condition prevention, medication management, and more. Provider Portal User's Guide Accessing and Registering PRD1015-1E (5/20) CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc., and Group Hospitalization and Medical Services, Inc. which are independent licensees of the Blue Cross and Blue Shield Association.View, order or email member ID cards; Check claims and deductible status; Manage your health plan information, and more! To access your personalized plan information …Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site.Blue365 Discount Program for Members; Whole Health Benefits; Health Resources; Health Information, Tips & Tools; Dental Wellness Library; Healthy Pregnancy; Share Your Story; Vitality; 24-Hour Nurse Advice LineLogin. Forgot password? Retrieve. Don’t have an account? Create. Public users? Event login here. return to CFC website. CFC & Family Ministries Members Portal ©2024 | -rptesoro-.

Employee & Member Login Login to your accounts for Benefits Enrollment and COBRA. Benefits Enrollment Enroll in your benefits, make changes or simply learn about your plans - all in one place. Login. COBRA Discover your options and make payments to continue your health care coverage.Member Login. Behavioral Health & Addiction. Live Your Best Life. Living your best life involves good physical and mental health. ... *Magellan Healthcare Provider Group is an independent company that provides behavioral health services to CareFirst members. Get Support Today. If you or someone you know is in crisis, call or text 988 or contact ...Live Chair reaches out to CareFirst CHPMD members each month to act as an access point into the healthcare system, helping members understand their benefits, find a physician and schedule preliminary appointments to improve preventative care. Ryse Health. Ryse Health (Ryse) pairs CareFirst members with uncontrolled Type 2 Diabetes with Ryse ...Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site.Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site.

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Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site.CareFirst BlueCross BlueShield Advantage DualPrime is a Medicare Advantage Prescription Drug Plan for those with both Medicare and Medicaid (Maryland Medical Assistance Program) as a Qualified Medicare Beneficiary (QMB) or a Full Benefit Dual Eligible (FBDE). This plan combines your Medical, Hospital, and Prescription Drug coverage with extra ...Access CareFirst Direct Today! Click 'Register' or 'Login' on the upper right-hand corner of this page to verify eligibility and benefits, check claim status, access remittance information, and more - online and on your own time. Access our user guides for assistance.CareFirst BlueCross BlueShield Advantage DualPrime is a Medicare Advantage Prescription Drug Plan for those with both Medicare and Medicaid (Maryland Medical Assistance Program) as a Qualified Medicare Beneficiary (QMB) or a Full Benefit Dual Eligible (FBDE). This plan combines your Medical, Hospital, and Prescription Drug coverage with extra ...Phone Numbers (Monday-Friday, 8 a.m. to 6 p.m. and Saturday, 8 a.m. to noon) Current members with renewal questions. 855-300-7751. Individuals interested in purchasing insurance. 800-544-8703. Looking to renew or change your CareFirst BlueCross BlueShield plan?

Member Login. Forgot Username? Forgot Password? Having trouble logging in? Call Technical Support at 877-526-8390. Provider Access Information. Two Separate FSA Options: CareFirst offers the following options: Health Care Expense Reimbursement - Participants can pay for eligible health care expenses on a pretax basis, thereby cutting costs by reducing their federal income tax, FICA tax, and in most states, their state income taxes. Typical out-of-pocket health care expenses include, but are not limited to:If you're a healthy person, you'll most likely have to wait until one of the later phases to get vaccinated, which could take several months. Learn more about the vaccine distribution plans in Maryland, Washington, D.C. and Virginia. Or for information on COVID-19 vaccination in your area, please contact your local health department.CareFirst BlueCross BlueShield Family of Health Care Plans > Portal Login. Please Login to MyHealthPortal. Email Address: Password:For a complete and detailed description of benefits, check the 2024 BlueChoice Brochure (PDF) A new patient-centric, virtual-first primary care practice. Compassionate care for over 100 conditions through an easy-to-use app. 24/7/365. CloseKnit's care teams offer preventive and urgent care, behavioral and mental health, chronic condition ...Member Login. Staying Healthy. What is Preventive Care? Blue365 Discount Program for Members; Whole Health Benefits; ... In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). ...Review our FAQs or call CareFirst WellBeing support at 877-260-3253. If you have questions about your health plan coverage, please call the number on the back of your member ID card. *Sharecare, Inc. is an independent company that provides health improvement management services to CareFirst members. Both CareFirst BlueCross BlueShield and ...What do I do? If your dental bill includes an additional charge for PPE for a visit between the dates of June 1, 2020 and October 31, 2020, please contact our customer service department by secure email through My Account, or by calling the number on the back of your member ID card.Member portal for Healthfirst accounts. You can now pay bills, access benefits, view claims and manage all your Healthfirst plan info in one place.Serving Maryland, the District of Columbia and portions of Virginia. CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association.CareFirst BlueCross BlueShield offers you a range of Medicare Advantage and Medicare Supplement (Medigap) plans to fit your specific needs and budget, and makes finding the right Medicare plan easy. Designed exclusively for the residents of Maryland, Washington, D.C. and Northern Virginia, our Medicare plans help protect your health and your ...In today’s digital age, accessing important information and services online has become the norm. The UAN Member Portal is a valuable tool that allows members to conveniently access...

In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (Used in VA by: First Care, Inc.). First Care, Inc., CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc. and The Dental Network are independent licensees of the Blue Cross and Blue Shield Association.

CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri. May 3 at 9:30PM to 11:30PM for all members. CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri. May 3 at 11:30PM to May 5 at 9PM for FEP, NASCO and Out of Area members. Provider Portal will be unavailable Sat. May 4 from 6PM to 8PM.Explore the Redesigned Member Portal Homepage. Get easier access to everything you need to understand your coverage. Log in or Register. Find a Doctor. We've got you …Member Login. Go to Media News Archives. For more information, contact us: CareFirst Media Relations 1-800-914-NEWS (6397) ... CareFirst WellBeing provides members with a single-entry point to connect with all the solutions, tools and programs available, making it easier to manage every aspect of wellbeing—from physical fitness and family ...Serving Maryland, the District of Columbia, and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO ...September 27, 2017 - Provider Portal (CareFirst Direct) Functionalities Got an Upgrade. Four New User Guides Can Help You Navigate. Have you logged into the Provider Portal (CareFirst Direct) recently?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. CareFirst CHPMD Members whose medical care has been impacted by ...In today’s digital age, it is essential to prioritize the security of our personal information when accessing online platforms. This holds true for Optavia members who use the Opta...Member Login. Electronic Explanation of Benefits (EOB) Frequently Asked Questions ... Explanation of Benefits or E-EOB is a weekly summary of medical and dental claims that have been processed by CareFirst and CareFirst BlueChoice. E- EOBs will display details about claims processed for you, your spouse and/or dependents (if applicable ...

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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. CareFirst CHPMD Members whose medical care has been …Member Login. BlueChoice (HMO) Forms. If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. ... CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield ...Virtual-First Primary Care Practice. CloseKnit is a 24/7/365 patient-centric, easy-to-use app providing compassionate care for over 100 conditions. CloseKnit's care teams offer preventative and urgent care, behavioral and mental health, chronic condition prevention, medication management, and more. Learn More.Member Login. Programs for Your Health. Wellness Program; Behavioral Health. Substance Use Recovery; Opioids and Addiction Support ... In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used in VA by: First Care ...May 3 at 11:30PM to May 5 at 9PM for FEP, NASCO and Out of Area members. Provider Portal will be unavailable Sat. May 4 from 6PM to 8PM. Change Healthcare ...Register for My Account for secure online access to your coverage details, ID card and more - day or night! From your computer, mobile device or the CareFirst app, you can: Find in-network doctors, specialists, urgent care centers and more—nationwide—including a map and directions to the location 1. Check plan information including.Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site.Member Service Phone Numbers (Monday-Friday, 8 a.m. to 6 p.m.) Members who bought ACA Plans directly from CareFirst (off exchange) 855-444-3122. Members who bought ACA Plans through State Websites (on exchange) 855-444-3121. Members with Grandfathered/Non-ACA Plans 800-722-2467. Medigap Members 800-722-2235. CareFirst Engagement Centers:CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri. May 3 at 9:30PM to 11:30PM for all members. CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri. May 3 at 11:30PM to May 5 at 9PM for FEP, NASCO and Out of Area members. Provider Portal will be unavailable Sat. May 4 from 6PM to 8PM. ….

CareFirst BlueCross BlueShield offers you a range of Medicare Advantage and Medicare Supplement (Medigap) plans to fit your specific needs and budget, and makes finding the right Medicare plan easy. Designed exclusively for the residents of Maryland, Washington, D.C. and Northern Virginia, our Medicare plans help protect your health and your ...CareFirst MemberMember Login. BlueChoice (HMO) Forms. If you need a form that is currently not available online, please call Member Services at the telephone number on your ID card. ... CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield ...Account Login. Access to this system is only allowed for authorized users. Our login process better protects the privacy and security of your personal information. ... Carefirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc., an ...To view the information you need, please be sure to have the membership ID and patient's date of birth. Log in to the Provider Portal at provider.carefirst.com. You can search for a Member to check their Eligibility and Benefits information directly from the CareFirst Direct home page. We recommend checking eligibility and benefits every ...In today’s digital age, organizations across various industries are realizing the importance of member portals in driving growth and enhancing member engagement. A member portal is...Select the correct Member by clicking on the next to his/her name. Under 'I would like to see', select 'Claim Status'. Once you select Claim Status, a drop down will appear allowing you to enter a Date Range. You have the following options: To view a specific claim, click on the corresponding 'Claim Number' hyperlink.Contact CareFirst Medicare Supplement MedPlus Member Services, at 800-722-2235 8 a.m.-6 p.m., ET, Monday through Friday. Shop for a Plan Find the Medicare plan that's right for you.For CareFirst BlueCross BlueShield members, this graphic shows the most requested information when you receive care. 1 Member ID (also called a subscriber number or patient ID)—the number providers need to verify coverage. Carefirst member portal, Member Login. Video Visit - Urgent Care. See a board-certified doctor 24/7/365 without an appointment on your smartphone, tablet or computer. Doctors can treat common health issues and write a prescription if appropriate. The cost for your Video Visit varies depending on your benefits, but the cost will be visible to you before you begin your ..., Group Plan Medical Forms. These forms are to be used if you have a group plan you bought through your employer. If you are unsure of what plan you have, look on your Member ID card. You may contact Member Services by calling the telephone number on your card. Other Member Services contact numbers are also available. Group Medical Plans., Now, CareFirst BlueCross BlueShield's (CareFirst) innovation and investment arm, Healthworx, is pushing virtual care even further, welcoming its new virtual-first, primary care practice called CloseKnit. Mary Jane Favazza, CEO of CloseKnit, and Mike Bautista, Director of Commercialization, Healthworx, spoke with Technical.ly about the recent ..., Headquartered in Baltimore, and designed by CareFirst's innovation and investment arm, Healthworx, CloseKnit is a one-stop shop for primary and integrated care delivery. The practice's care teams treat most cases virtually and provide in-person care through referrals to local providers when needed. CloseKnit is open 24/7/365 and staffed by ..., Member Login. Go to Media News Archives. For more information, contact us: CareFirst Media Relations 1-800-914-NEWS (6397) ... These latest benefits, combined with other relief CareFirst has offered, result in over $300 million made available to CareFirst's members, providers, and communities during the COVID-19 pandemic. ..., Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site., Contact CareFirst Medicare Supplement MedPlus Member Services, at 800-722-2235 8 a.m.-6 p.m., ET, Monday through Friday. Shop for a Plan Find the Medicare plan that's right for you., Member portal for Healthfirst accounts. You can now pay bills, access benefits, view claims and manage all your Healthfirst plan info in one place., Login Timeout. Your My Account session is about to expire. ... CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site. ..., DC Medicaid/Alliance and Me. Answers and More>>. Latest News. Nursing Facility Rate Increase Effective May 1, 2024. Suboxone and Buprenorphine-Containing Products Daily Dosing Limit Increase. All Late Breaking News>>. What's Hot?, Convenient Virtual Care Options. At CareFirst, we want you to be able to connect with the right care 24/7. Below are several virtual care options that let you meet with credentialed doctors, clinical experts or dedicated care teams--anytime, anywhere. You’ll get immediate access to care, or you can make an appointment that fits your schedule., The CareFirst Preferred Drug List represents a summary of Formulary 2 and is a guide to help you identify drugs that are both clinically appropriate and cost-effective. $0 Select Generics This is a list of preventive drugs used to treat certain chronic conditions that are available at no cost (including no deductible) for members in fully ..., Your member ID card identifies you as a member of a health plan. It shows important information about you and your covered benefits. You should always present your ID …, Filing of nominations by members is mandatory as per para 33, 34 and 61 of EPF Scheme,1952. It is also required for filing online Death Claims (Form10-D, 20 and 5-IF). E-Nominations can be filed and updated by member during his/her service period., CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri. May 3 at 9:30PM to 11:30PM for all members. CareFirst Direct Eligibility/Benefits and Claims Status will be unavailable Fri. May 3 at 11:30PM to May 5 at 9PM for FEP, NASCO and Out of Area members. Provider Portal will be unavailable Sat. May 4 from 6PM to 8PM., Member Login. Health Coverage. Medical, Dental & Vision Plans. Blue High Performance Network; How to Find In-network Care; Where BlueHPN is Available ... In the District of Columbia and Maryland, CareFirst MedPlus is the business name of First Care, Inc. In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used ..., As a business owner, it is important to provide your employees with the tools they need to succeed. Wellpath’s employee portal is one such tool that can help you do just that. Anot..., 5-tier drug plan; Drug Tier (cost-share) Definition; Tier 0 $0 Drugs: Preventive drugs (e.g. statins, aspirin, folic acid, fluoride, iron supplements, smoking cessation products and FDA-approved contraceptives for women) are available at a zero-dollar cost share if prescribed under certain medical criteria by your doctor., Member Login. Health Coverage. Medical, Dental & Vision Plans. Medicare Plans; ... Medicaid Plans. CareFirst BlueCross BlueShield Community Health Plans provides health coverage for Medicaid recipients in Maryland and District of Columbia. Medicaid is a joint federal and state program. CareFirst Medicaid insurance plans provide high-quality ..., Member Login. Find a Doctor. Search for a Doctor/Facility. Why Choose a PCP? Options for Care. ... CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage ..., These plans cover one member. CareFirst offers HMO and PPO plans with deductibles and monthly costs to meet your budget. Plans offer core health benefits and preventive services, including: Prescription drugs; Preventive care; Vaccinations; Hospital and emergency services, Member Login. Research a Doctor or Hospital. Blue Distinction Specialty Care; Compare and Research Doctors and Hospitals ... In Virginia, CareFirst MedPlus is the business name of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage ..., Login. Don't have an online account? Register at the Synchrony site for access. FOR PROVIDERS. Are you an enrolled existing provider? Access tools and resources that enable you to help more patients get the care they need. Login. New to CareCredit? Register Now. Want to accept CareCredit at your practice? Talk to our team., Serving Maryland, the District of Columbia, and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueCross BlueShield Medicare Advantage is the shared business name of CareFirst Advantage, Inc., CareFirst Advantage PPO ..., Blue Cross and Blue Shield of Illinois is proud to be the state's only statewide, customer-owned health insurer. We are also the largest provider of health benefits in Illinois, serving more than 8.9 million members in all 102 counties across the state. For more than 85 years, we've provided our members with comprehensive, affordable health ..., Make payments using cash and/or a debit card, using your PIN, without any transaction fee. Check or money order payment. Mail a check or money order and invoice stub to: Payment Administrator. PO Box 70250. Philadelphia, PA 19176-0250. Make payable to: CareFirst BlueCross BlueShield. Include your name, member ID number and group number on the ..., CareFirst Administrators (CFA) is the only third-party administrator in Maryland, D.C. and Northern Virginia providing flexibility and superior service, through the most trusted name in health care—locally through CareFirst BlueCross BlueShield, and nationally through the Blue Cross Blue Shield Association., Drug Search – Search for a specific drug, find out if it is covered, what tier it falls under and if any restrictions apply.; Find a Pharmacy – See if your local pharmacy is in the CareFirst network or use this tool to find a network pharmacy near you.; Drug Forms – Find the forms you need to submit a claim, set up mail order for your prescriptions and more., Group Plan Medical Forms. These forms are to be used if you have a group plan you bought through your employer. If you are unsure of what plan you have, look on your Member ID card. You may contact Member Services by calling the telephone number on your card. Other Member Services contact numbers are also available. Group Medical Plans., Note: Blue High Performance Network SM (BlueHPN SM) members have limited benefits at the University of Maryland Medical System Downtown Campus. CareFirst medical staff, with appropriate consultation, reserves the right to not cover certain drugs, services, treatment or supplies that may be experimental or investigational, excluding clinical trials., Serving Maryland, the District of Columbia and portions of Virginia, CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc. and First Care, Inc. are affiliate companies and also offer health benefit products and services on this site. , If requesting an authorization for a CareFirst employee, fax the request to 410-505-2840. Please submit this completed form only ... Member's Identification Number Group Number Address Phone City State Zip Code Date(s) of Service or Admit Date(s) ... Office for Civil Rights electronically through the Office for Civil Rights Complaint portal ..., Members in HMO plans should reference his/her member contract to determine if referrals for specialist services are required. Members may also discuss referral requirements with their Primary Care Provider, who will provide a referral when needed. Referrals may be for a single visit or multiple visits, also referred to as a standing referral.