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INSURER FILING GUIDE

FEP Blue, Federal Employee Program, as administered by CareFirst in Maryland (and the national FEP member claim path)

Use this public information to prepare your packet, then confirm the route on the insurer's own page.

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AT A GLANCE

Claim facts

Member form

BlueCross BlueShield Federal Employee Program Health Benefits Claim Form

Number: 4F1-19049-F

Revision: 09/21

Open the insurer form
Portal uploadYES
Portal pathFor FEP Blue Standard, select the public online domestic-claim option and sign in to MyBlue; exact post-login path is UNREADABLE
Mail addressPLAN-DEPENDENT: Submit to your local Blue Cross and/or Blue Shield Plan; locate the mailing address at www.fepblue.org/contact.
FaxNot published by the insurer
AttachmentsProvider name and address; full patient name; date and type of service or supply; charge for each service or supply; diagnosis; provider identification number
DeadlineBy December 31 of the calendar year after the year of service
Outcome and statusMyBlue EOB view; local Blue plan claim status
Processing timeDecision within 30 days after receipt; up to 15 additional days when an extension is required
CaveatsThe local Blue plan where service was rendered processes the claim, so CareFirst handles Maryland service; Standard has out-of-network benefits, while Basic and Focus coverage limits differ; Medicare Advantage and Medicaid are outside this row

STEP BY STEP

Filing steps

Source: https://www.fepblue.org/-/media/PDFs/Forms/2024/FEP-Health-Benefits-Claim-Form_Final-1222.pdf

Read date: 10-09-2026

Research steps

  1. Identify the option. FEP Blue Standard publishes an online domestic claim route. FEP Blue Basic and FEP Blue Focus publish no member upload route and require the non-upload process. FEP Blue claim submission
  2. Complete the fillable Federal Employee Program Health Benefits Claim Form 4F1-19049-F, one per patient, and sign item 7. FEP Health Benefits Claim Form
  3. Attach itemized bills showing provider name and address, full patient name, date and type of service or supply, charge for each service or supply, diagnosis, and provider identification number. A CMS-1500 is also accepted under the 2026 brochure, but is not required when the member form is used. FEP Health Benefits Claim Form 2026 FEP Blue brochure
  4. For Standard, select the public online domestic-claim option and sign in to MyBlue. UNREADABLE: exact post-login menu, file types, size, count, grouping, confirmation, and whether the online flow uses the PDF. FEP Blue claim submission
  5. Submit by December 31 of the year after the year of service. The local Blue plan where service was rendered processes the claim, so CareFirst is the local administrator for Maryland service. FEP Blue claim submission
  6. View the EOB in MyBlue. The 2026 brochure says the plan will notify the member of its decision within 30 days after receipt, with up to 15 additional days when an extension is required. FEP Blue claim submission 2026 FEP Blue brochure

Filing facts

  • Portal upload: YES
  • Portal: MyBlue
  • Portal path: For FEP Blue Standard, select the public online domestic-claim option and sign in to MyBlue; exact post-login path is UNREADABLE
  • Mail address: PLAN-DEPENDENT: Submit to your local Blue Cross and/or Blue Shield Plan; locate the mailing address at www.fepblue.org/contact.
  • Fax: NOT PUBLISHED
  • Attach: Provider name and address; full patient name; date and type of service or supply; charge for each service or supply; diagnosis; provider identification number
  • File types: NOT PUBLISHED
  • File size limit: NOT PUBLISHED
  • Maximum files: NOT PUBLISHED
  • One file or separate files: NOT PUBLISHED
  • Confirmation: NOT PUBLISHED
  • Status check: MyBlue EOB view; local Blue plan claim status
  • Processing time: Decision within 30 days after receipt; up to 15 additional days when an extension is required
  • Member deadline: By December 31 of the calendar year after the year of service
  • Deadline basis: Online domestic filing is published for Standard only; Basic and Focus use the non-upload route; FEHB and PSHB brochures and legal-incapacity exceptions can differ
  • Mental health route: No separate mental-health member claim portal is published; the national medical claim route applies

Confirm the address, fax number or portal path on the insurer's own claims page before you send; read on 10-09-2026.

Read on 10-09-2026 from https://www.fepblue.org/-/media/PDFs/Forms/2024/FEP-Health-Benefits-Claim-Form_Final-1222.pdf. Confirm the address, fax number or portal path on the insurer's own claims page before you send.