Due to an upgrade to the CareFirst Broker Portal, on 1/6/2023, your current password will need to be reset using the "Forgot Password" link on the login page. Should you have any issues please use the Help Desk number on the login page for support.
Maryland Group Applications and Forms
A variety of applications and other forms are available.
Please contact your Account Manager or Broker Representative to ensure that you have the correct forms. Please choose from the list below:
|Authorization Form for Information Release|
|Personal Representative Form|
|Revocation Authorization Personal Representative Designation|
|Access to PHI Form|
|Accounting of Disclosures|
|Amendment to PHI Form|
|Restrict PHI Form|
|Terminate Restriction to PHI Form|
|Request for Confidential Communications Form
This form should be returned to:
CareFirst BlueCross BlueShield