You can visit CareFirst BlueCross BlueShield website to find more information.

API stands for Application Programming Interface, which is a software intermediary that allows two applications to talk to each other. An API product bundles resources (such as API proxies) to provide a specific level of access and functionality for client app developers. On the other hand, an API product typically specifies a list of API proxies, along with access limits, API key approval method and other configurations that should be in place for all the bundled proxies.

Please sign in to see what products can be subscribed to by your application. You can see the applicable products on the API Products page.

Please send a request using the Contact Us form with the subject "Application Approval Request."

On May 1, 2020, CMS published the CMS Interoperability and Patient Access final rule (CMS-9115-F) to establish policies that advance interoperability and patient access to health information. The rule required MA organizations, Medicaid managed care plans, CHIP managed care entities, and QHP issuers on the FFEs (collectively referred to as "impacted payers") to facilitate enhanced data sharing by exchanging data with other payers at the patient’s request. Please refer link Payer-to-Payer Data Exchanges on CMS website for more details.

Payer-to-Payer questionnaire document can be downloaded from this link.

Please send an email to DeveloperPortalSupport@carefirst.com with details about your concern.

The CMS Rule requires regulated Health Plans to provide the following APIs:

1. Patient Access API: The Patient Access API requires a Health Plan member to authorize access to their data. This API is inclusive of Carin BB and US Drug FHIR Implementation guides.

2. Provider Directory: This is a public facing API not requiring authorization from the member. This API implements Plan-Net FHIR guides.

3. Payer-to-Payer Data Exchange: Ability for health plans to share health information with another health plan to which the member transitions.

Please look into API Products and API documentation for more details.

Please register your application with the details requested as part of the application registration flow.

Developer attestation: This attestation (part of the CMS mandate) is separate from and not a part of CareFirst approval for API access. We encourage all developers who comply with the requirements of the Attestation to submit this during registration. Members requesting patient access for an application without the attestation will be shown a warning message to that effect.

CareFirst is taking a "Patient first" approach and supporting a growing number of HL7 FHIR Implementation Guides in addition to Non-FHIR APIs. You will be able to request access to FHIR Patient Access APIs for as well as network of contracted providers via the Provider Directory API for eligible CareFirst Plans and providers network using Provider API.

CareFirst provides a developer portal for developers to register. Please click the "Register" link on the top menu of this portal. You will need to provide your email address, phone and other details to register you as a developer during the registration process. Once your registration is complete, you can login as developer on the portal.

You will be able to view your application credentials, i.e., API Key and API Secret, once your application is approved via the developer portal. Please navigate to the list of your applications after login and click View Credentials.

Please register your application with the details requested as part of the application registration flow.

Please send a request using the Contact Us form with the subject "Application Approval Request."

To register your Brokerage Agency company account, you should choose the "Developer from Brokerage Agency" option. This type is perfect if your main focus is on health insurance brokerage services, as it enables you to manage and integrate various brokerage-related functionalities seamlessly.

Before registering as a Brokerage Agency company account, you need to prepare the following information:

First, you will need your Agency/Brokerage EIN number if your company is Brokerage Agency/Entity. This will be used to validate the group setup for your Brokerage Agency/Entity.

Next, gather your company information. This includes your business legal name, company email domain to be used for all business/account login communications, physical addresses, company phone, website URL, and customer support email/phone. Ensure you have the correct company email domain, street address, city, state, and zip code.

You also need to ensure that the primary person registering the account is authorized to do so on behalf of the company. Provide business/work contact details for primary and secondary authorized persons. The primary and secondary authorized persons can be technical contacts with work emails.

Lastly, before registering, we suggest you create an email distribution list (DL) with the company email domain provided earlier to include your technical person(s) who can log in to the CareFirst Developer Portal. The benefit of an email DL is that your authorized person can manage access to the CareFirst Developer Portal. This account email address will be used to log in to the developer portal.

Having this information prepared will streamline the registration process and help avoid any delays.

To register a company account for a Brokerage Agency, the eligible person must be an authorized technical individual in the role of manager or above. This person should own and manage the application and its credentials. Additionally, the authorized person should be responsible for managing the people included in the account email distribution list. This ensures that only qualified and responsible individuals have access to the account and can oversee its proper use.

The point of contact for customer service should be a support email distribution list (DL) that includes the email addresses of technical personnel. This primary authorized individual should be able to identify and provide the technical support email address and phone number for any technical conversations between CareFirst and the company. This setup ensures that all technical inquiries are handled efficiently and by the appropriate personnel.

Using a company email domain for account registration is essential for several reasons.We use a company email domain to ensure that all business communication is conducted using this domain and not personal email addresses like Gmail, Yahoo etc. All email addresses are validated to use this domain.