CareFirst BlueCross BlueShield Community Health Plan District of Columbia
Welcome to the CareFirst BlueCross BlueShield Community Health Plan District of Columbia Health Plan page. Here you can download policies and procedures specific to both ordering and rendering providers. These include quick reference guides and information designed to assist you in using RadMD to request and check the status of prior authorizations.
If you have any questions about our programs, please contact your dedicated NIA Provider Relations Manager, Charmaine Everett.
Advanced Imaging Program
- Cardiac Checklist
- Cardiac Frequently Asked Questions
- Frequently Asked Questions
- Provider Education Presentation
- Quick Reference Guide for Imaging Facilities
- Quick Reference Guide for Ordering Physicians
- Utilization Review Matrix-2022 - Updated 7/1/2022
- Peer-to-Peer Process
- Tip Sheet for Ordering Advanced Imaging Studies
- Tip Sheet for Pediatrics
- Tip Sheet for Cardiac Solutions
- Tip Sheet MPI vs. Stress Echo
Conservative Treatment Forms
For access to our conservative treatment forms, click here.
RadMD is a user-friendly, real-time tool offered by Magellan Healthcare that provides ordering and rendering providers with instant access to prior authorization requests for specialty procedures. Whether submitting exam requests or checking the status of prior authorization requests, providers will find RadMD to be an efficient, easy-to-navigate resource.
Search for resources by program:
Recorded General Trainings
We have a series of training videos that discuss the components of requesting a prior authorization request. Click here to access these videos.
Recorded RadMD Demos
Need additional help using RadMD? Click here to access a series of RadMD demos that demonstrate how to properly submit a prior authorization request.
- Clinical Guidelines
Refer to the Utilization Review Matrix document to view specific codes managed by NIA
Clinical Training Modules
We have a series of clinical training modules that will help you avoid delays and ensure that you have the right information before submitting your prior authorization request. Click here to access them.
Update on COVID-19
Click here to view our recommendations on the use of CT to detect Coronavirus (COVID-19).