Carelon Post Acute Solutions, formerly myNEXUS, is a utilization review accreditation commission (URAC) certified, innovative, technology-driven care management company focused on serving and keeping clients in their home through intelligent, connected care. Carelon provides delegated benefit management services for post acute care, including utilization management (UM) and claims payment services.
Carelon has dedicated staff and resources to support your participation in our network by providing:
- Technology-driven care management services for members to keep them healthy and independent in their home
- Administrative and benefit management services delivering quality outcomes for services traditionally provided in the home
- The appropriate care to members at the right time
- Lower costs to the health care delivery system by preventing unnecessary readmissions
Carelon is excited to partner across the healthcare ecosystem, from trade associations to technology, from care delivery to care coordination, from suppliers to systems, in order to bring communities of caring together to better serve people. We focus on the delivery of cost effective services that reduce risks, promote independence, and improve quality of life for members and families.
• Contracting: Please find the Carelon Post Acute Solutions contracting information form here.
Carelon Post Acute Solutions
105 Westwood Place | Suite 400 | Brentwood, Tennessee 37027
Provider call center phone: 844-411-9622
An individual shall not be excluded from participation in, be denied the benefits of, or be subjected to discrimination on the grounds prohibited under Title VI of the Civil Rights Act of 1964, 42 USC § 2000d et seq. – PDF (race, color, national origin, sex, age, sexual orientation, gender identity, and disability), Title IX of the Education Amendments of 1972, 20 USC § 1681 et seq. – PDF (sex), the Age Discrimination Act of 1975, 42 USC § 6101 et seq. (age), or Section 504 of the Rehabilitation Act of 1973, 29 USC § 794 – PDF (disability), under any health program or activity, any part of which is receiving Federal financial assistance, or under any program or activity that is administered by an Executive Agency or any entity established under Title I of the Affordable Care Act or its amendments. OCR has enforcement authority with respect to health programs and activities that receive Federal financial assistance from the Department of Health and Human Services (HHS) or are administered by HHS or any entity established under Title I of the Affordable Care Act or its amendments. Carelon Post Acute Solutions employs industry standard information security systems including, but not limited to: Unified Threat Management (UTM), Vulnerability Threat Management (VTM), Data Loss Prevention (DLP), and Security Information and Event Management (SIEM), Email Encryption, and Secure Sockets Layer (SSL) certificates. Inquiries regarding Carelon’ information security and privacy policies, procedures or activities may be directed to the Privacy Team through email.