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. ® Registered trademark of the Blue Cross and Blue Shield Association. ®′ Registered trademark of CareFirst of Maryland, Inc. PROPRIETARY AND CONFIDENTIAL Montgomery County Medical Society Rockville Hilton October 25, 2012

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. ® Registered trademark of the Blue Cross and Blue Shield Association. ®′ Registered trademark of CareFirst of Maryland, Inc. PROPRIETARY AND CONFIDENTIAL Current Initiatives

PROPRIETARY AND CONFIDENTIAL Patient Centered Medical Home (PCMH) 3 CareFirst launched its PCMH program in January The Program has grown to its current size quickly and now involves nearly 1,000,000 CareFirst subscribers, making it the largest program of its type in the nation. PCP participants now represent approximately 80 percent of all eligible primary care physicians in CareFirst physician networks. In the first 18 months of the program, CareFirst has significantly enhanced the tools, resources, and supports available to PCMH participants. These enhancements include: –A detailed online member health record and online care plan development tool available 24/7 via the internet. –Comprehensive data on their CareFirst patient population to identify opportunities for care improvement and cost savings. –Teams of registered nurses, community-based Local Care Coordinators and CareFirst Regional Care Coordinators, aligned with individual practices to help coordinate care for the sickest patients. –A team of PCMH Program Consultants to help participants understand and utilize the tools and data available through the program. –Free access to the American College of Physicians Medical Home Builder 2.0 tool to assist practices in transforming to a medical home model. –Dedicated member service resources for CareFirst PCMH members.

PROPRIETARY AND CONFIDENTIAL Choose Electronic Claim Submission 4 Electronic Submission (EDI): Consistent data requirements versus completing a paper claim. Decreases claim returns for additional information. Faster payment Enhances your record keeping abilities. Electronic Fund Transfer (EFT) is available through Real Med, Emdeon and Allscripts. Medicare secondary claims can now be submitted electronically- see the news item in carefirst.com.>provider& physician>news section.

PROPRIETARY AND CONFIDENTIAL On-line Eligibility and Claim Status Tools 5 Using CareFirst Direct and the Voice Response Unit ( VRU): Saves time waiting for a Customer Service Representative. When you must call, Provider Service will focus on your more complicated claim inquiries. Consistent Eligibility and Claim Information is found in the on-line tools. CareFirst is constantly enhancing CareFirst Direct and the VRU. Make sure that your agents/vendors, that do your billing and follow-up, have access to CareFirst Direct. We have several instructional webinars a month to train your staff or agents.

PROPRIETARY AND CONFIDENTIAL CareFirst’s Website 6 “One-Stop” shopping for CareFirst information – and physicians. Product and General Information manuals Access to CareFirst’s Medical Policy Access to CareFirst’s bi-monthly newsletter- BlueLink Credentialing information in the “Quick Links” section of the website Job Aids Forms Critical news blasts Access to CareFirst Direct Register for instructional Seminars and Webinars Companion Guide for the 5010 transaction sets ICD10 updates

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. ® Registered trademark of the Blue Cross and Blue Shield Association. ®′ Registered trademark of CareFirst of Maryland, Inc. PROPRIETARY AND CONFIDENTIAL Enhanced Provider Curriculum

PROPRIETARY AND CONFIDENTIAL New Learning Curriculum for Providers 8 Suggested Curriculum for new providers or providers that would like a refresher: Session 1- New Provider Introduction- overview of the expectations and training available for providers Session 2 - Specialty Specific Contract Information (Institutional Ancillary Providers only) Session 3 – Programs and Products – overview of CareFirst Products and corresponding membership cards Session 4 - Claims Submission Requirements- overview of how to file claims to CareFirst Session 5 – Corrected Claims Submission, Inquiry and Appeal Procedures- a “how to” for electronic claim correction. Also includes how to file an inquiry or an Appeal. Session 6 – Self-Service Tools - CareFirst Direct – Eligibility and Benefits Session 7 – Self-Service Tools – CareFirst Direct – Claims Status and Inquiry Session 8 - Voice Response Unit (VRU) Additional topic specific webinars we encourage you to take: –Blue Card, Blue Choice, HealthyBlue, Physical, Occupational and Speech Therapy, OB/GYN Care

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. ® Registered trademark of the Blue Cross and Blue Shield Association. ®′ Registered trademark of CareFirst of Maryland, Inc. PROPRIETARY AND CONFIDENTIAL General Updates

PROPRIETARY AND CONFIDENTIAL from CareFirst 10 Crucial Information is being shared via . CareFirst typically only sends updates once a week. Please sign-up to receive s at and physicians>news. CareFirst only uses your address for notification purposes.

PROPRIETARY AND CONFIDENTIAL Fee Schedule 11 Fee Schedule letters dated 10/1/2012 were mailed or delivered to groups with a 12/1/2012 effective date. Top 100 fees we included in the mailing, and there is an address to request additional codes For more information please refer to the letter dated 10/1/2012.

PROPRIETARY AND CONFIDENTIAL Voucher Enhancements 12 CareFirst is making changes to the Facets voucher format. These enhancements to the format will aid in understanding the information on the voucher. We anticipate these enhancements to be in the near future. We will post the effective date and training webinars available for these changes on carefirst.com, and in the BlueLink.

PROPRIETARY AND CONFIDENTIAL NPI Reminder 13 The National Provider Identifier (NPI) must be used on all claims submissions. This includes electronic and paper claims.