Due to a planned data migration beginning Friday, July 11 at 11:00 p.m., and continuing through Monday, July 14 at 8:00 a.m., you may experience a delay in your information appearing on CareFirst portals. We expect that changes to member data will be reflected on the portals by Tuesday, July 15. Your patience is appreciated.
Change Healthcare notifying individuals of data breach. Learn more here.
Virginia 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 |