Carelon Medical Benefits Management recognizes the key role that medical practices play in the delivery of care for patients with cardiovascular disease. Developed in collaboration with your patients’ health plans, our Cardiology program helps support quality care that is consistent with established best practices. And that’s good news for your practice and the patients you serve.
Based on the clinical information you submit, we conduct clinical appropriateness review of your requests against clinical guidelines and health plan medical policies, providing you with a central location to obtain authorizations required by your patients’ health plans.
Our review process encompasses certain outpatient invasive and noninvasive diagnostic and interventional procedures including, but not limited to*:
- Coronary angiography
- Arterial ultrasound
- Stress echocardiography (SE)
- Resting transthoracic echocardiography (TTE)
- Transesophageal echocardiography (TEE)
- Percutaneous coronary interventions (PCIs) such as coronary stents, balloon angioplasty and atherectomy
- Peripheral Revascularization
Implantable cardiac devices:
- Implantable cardioverter defibrillators
- Cardiac resynchronization therapy
*Note: procedures reviewed may vary by health plan
Everyone I know that uses the online portal thinks it is the easiest one in the industry to use. And your clinical reviewers are always kind and make our jobs easy.
- Provider practice feedback
The Carelon provider portal experience
Learn to enter your cardiology services order request online.
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Powered by our pioneering provider portal technology, your requests are process in real time, with most requests approved at intake.
For requests that require additional consideration, our team of nurses and physicians are available to consult with your practice.
Learn how to enter your order online
Log in to provider portal