Blue Cross Blue Shield in Virginia: Anthem and CareFirst Billing Guide
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Virginia has two Blue companies. Anthem covers all of Virginia except the City of Fairfax, the Town of Vienna and the area east of State Route 123. CareFirst covers Northern Virginia. Check the member's ID card, then open the matching section.
Checked 10/1/26.
Anthem Blue Cross and Blue Shield of Virginia
For every Anthem state: Provider Services is 800-676-BLUE (2583). Claims go through the Availity EDI Gateway. Anthem's own EDI pages do not list payer IDs; they send you to the Availity payer list (EDI page). Credentialing is CAQH ProView plus Anthem's online enrollment, with as the contact. Availity Client Services is 800-282-4548. Anthem's Quick Contact Guides are 2025 editions; open the state PDF before you copy an address.
| Legal entity | Anthem Health Plans of Virginia, Inc. (service area is all of Virginia except the City of Fairfax, the Town of Vienna and the area east of State Route 123) |
|---|---|
| Paper claims (commercial professional) | Anthem, PO Box 105187, Atlanta, GA 30348-5187 |
| Appeals | Grievance and Appeals, PO Box 105568, Atlanta, GA 30348-5568 |
| Quick Contact Guide | Anthem Virginia guide |
| Provider services | 800-676-2583 |
| Timely filing | 90 days from the date of service for professional commercial claims received on or after 10/1/2019 per Anthem notice (Virginia notice). Your contract controls |
| State regulator | Virginia SCC Bureau of Insurance |
Northern Virginia members are on CareFirst. HealthKeepers is the Medicaid affiliate; its boxes and phones are not commercial.
CareFirst BlueCross BlueShield (Northern Virginia, Maryland, DC)
CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. (CareFirst provider manual, chapter 3). CareFirst says its legal entities, including CareFirst BlueChoice, Inc., are independent licensees of the Blue Cross and Blue Shield Association (October 2024 newsletter). It serves Maryland, Washington DC and Northern Virginia.
| Blue company | CareFirst BlueCross BlueShield; CareFirst BlueChoice |
|---|---|
| Provider site | provider.carefirst.com |
| Provider phone (eligibility and benefits you cannot get online) | 800-842-5975 |
| Behavioral health | Mental Health and Substance Use Disorder line, 800-245-7013 |
| Appeals (professional) | Mail Administrator, PO Box 14114, Lexington, KY 40512-4114 (October 2024 newsletter) |
| Credentialing | Complete CAQH ProView, then submit CareFirst's online authorization form. Credentialing inquiries 877-269-9593 or 410-872-3500 |
| State regulators | Maryland Insurance Administration; DC Department of Insurance, Securities and Banking; Virginia SCC Bureau of Insurance |
Private payer: claims details. Confirm CareFirst's payer ID, professional paper claims address and filing limit in the claims chapter of the provider manual in your portal.
Frequently asked questions
Which Blue covers Northern Virginia?
CareFirst BlueCross BlueShield covers Northern Virginia. Anthem covers the rest of the state, except the City of Fairfax, the Town of Vienna and the area east of State Route 123.
Where do Anthem Virginia paper claims go?
Commercial professional claims go to Anthem, PO Box 105187, Atlanta, GA 30348-5187.
How long do I have to file with Anthem Virginia?
Anthem announced 90 days for professional commercial claims received on or after 10/1/2019. Your contract controls.
How MCM South helps with Blue Cross Virginia
MCM South bills Blue plans for psychotherapists and psychiatrists in the states we serve. We verify benefits, submit claims electronically, follow up on denials and appeals, and handle credentialing. Get a free quote. If a Blue Cross Virginia claim is denied or credentialing stalls, we follow up for you.
MCM South currently serves practices in GA, MA, CT, TX, FL, NY, CO, TN, NC and IL, and has worked in all 50 states. If your state is not on that list, ask us. This page is operational guidance for billing, not legal advice. For real financial or legal exposure, talk to your attorney or compliance officer.
Related: Blue Cross by State · How Blue Cross Blue Shield Works · Billing Terms Glossary · CPT and E/M Code Guide · Who We Serve.
This is the MCM South guide to Blue Cross Virginia for therapists and psychiatrists: where claims go, how appeals work, and what to check first.
Want a billing team that handles this for you? MCM South bills for psychotherapists and psychiatrists. Get a free quote.