Transcription of IASH Fax Sheet - CareFirst
1 1 IASH Fax SheetThis form helps support your inquiry to the CareFirst Direct Inquiry Analysis and Control System. Please use this form when faxing your DETAILSDateTimeToIASH Inquiries UnitFromOffice PhoneFaxOffice Fax# of pages (including cover)FAX TO APPROPRIATE NUMBER LISTED BELOWFEPFACETSNASCO/BLUECARD UB04 Billers MD*: 410-561-7933 CMS 1500 Billers MD*: 410-561-7933 UB04 Billers DC: 301-470-5152 CMS 1500 Billers DC: 202-203-2209 UB04 Billers: 301-470-1890 CMS 1500 Billers: 301-470-8072 301-470-5157 REQUIRED INFORMATIONP rovider ID #Inquiry Analysis Control NumberComments*Excludes PG and Montgomery Counties, use UB04 Billers DC and CMS 1500 Billers DC fax NoticeUnauthorized interception of this communication could be a violation of Federal and State Law.
2 This communication and any files transmitted with it are confidential and may contain protected health information. This communication is solely for the use of the person or entity to which it was intended. If you are not the intended recipient, any use, distribution, printing or acting in reliance on the contents of this message is strictly prohibited. If you have received this message in error, please notify the sender and destroy any and all copies. Thank BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.
3 CareFirst BlueCross BlueShield Medicare Advantage is the business name of CareFirst Advantage, Inc. CareFirst BlueCross BlueShield Community Health Plan District of Columbia is the business name of Trusted Health Plan (District of Columbia), Inc. 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.). CareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst Advantage, Inc.
4 , Trusted Health Plan (District of Columbia), Inc., CareFirst BlueChoice, Inc., First Care, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. BLUE CROSS , BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield (6/20)
