Important updates
Ensuring Your Safety and Helping Post-Hurricane
To our providers and portal users:
In response to hurricanes Helene and Milton, we at Carelon wanted to reach out to ensure that you, your team and patients are well. Your combined safety and well-being are always a top priority for us.
If you are facing any challenges or need assistance during this time, please do not hesitate to reach out. We are here to support you in any way we can.
Thank you for your dedication and hard work, especially during these challenging times. Please stay safe and know we are with you.
Impacted BM post-acute providers / portal users can reach us with any needs / questions at:
- HHprovider_relations@carelon.com
- DMEprovider_relations@carelon.com
- PACprovider_relations@carelon.com
Impacted MBM specialty providers / portal users can direct any needs / questions to us at:
Carelon MBM to introduce multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals
Carelon Medical Benefits Management (MBM) will complete roll out of multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals in the next few days.
Effective September 20th, all post-acute NexLync provider portal users will begin using our multi-factor authentication. This will be a one time roll out and will be applicable for both existing users who have not yet migrated and new users.
What is multi-factor authentication (MFA)?
Multi-factor authentication (MFA) is a multi-step login process that requires system users to enter their username and password followed by additional information such as a code sent to their email or phone. In some cases, the additional authentication step may involve answering a secret question that’s been set up ahead of logging in. Another name that is commonly used for this type of authentication is two factor authentication or 2FA.
Why is MFA important?
Companies commonly use MFA authentication today to protect their own systems, but also to protect those using their systems. Requiring MFA helps protect all against security issues such as compromised login information and phishing attempts. A phishing attempt is an email that tries to obtain confidential information like credit card numbers, user names or passwords.
Additional information for post-acute NexLync portal users
Effective September 20th, all post-acute NexLync portal users will begin using our multi-factor authentication. This will be a one time roll out and will be applicable for both existing users and new users.
You will be automatically enrolled with the email that you used to register your portal account. Upon each sign in, users will be given the option to receive a one-time code either via their registered email or the authenticator app. Once you enter the verification code from your desired method, you should be able to access your portal account as you do today.
Carelon MBM has decided to implement this process in efforts to protect member information, our own systems and those utilizing our systems.
Please see Multi-factor authentication FAQ’s and Instructions below.
Multi-factor authentication FAQ: click here for FAQ
Multi-factor authentication instructions: click here for MFA Instructions
If you experience any issues with our MFA or need any further assistance, please reach out to the Portal Support team by completing this form here.
Provider Portal: As a reminder, our provider portal is the quickest and most efficient way to request authorization. If you have not already done so, we encourage you to sign up for the Carelon Provider Portal by clicking here.
Thank you for your continued partnership.
Carelon Post Acute Solutions will begin operating as Carelon Medical Benefits Management on April 1, 2024
On April 1, 2024, Carelon Post Acute Solutions (formerly known as myNexus) will begin operating as Carelon Medical Benefits Management. While documents that use the Carelon Post Acute Solutions name today, such as determination letters and provider forms, will adopt the new name, there will be no changes in the way you submit a case or to the contact information you use for checking case status.
Please see below for a list of frequently asked questions (FAQs). Additional questions can be directed to our provider relations team using the contact information below:
Home Health Providers: HHprovider_relations@carelon.com
PAC-IM (Post-Acute Institutional Management) Providers: PACprovider_relations@carelon.com
DMEPOS Providers: DMEprovider_relations@carelon.com
Thank you for your continued partnership.
Frequently asked questions |
|
| 1. Will there be any changes to the Carelon Post Acute Solutions provider portal? | 1. The name of our portal will be updated to reflect Carelon Medical Benefits Management branding. Additionally, the web address (URL) you use today will automatically redirect to a new Carelon site. There will be no changes to the case submission process. |
| 2. Are any phone number changes planned as part of this transition? | 2. No. Our inbound phone numbers will not change. The reference to Carelon Post Acute Solutions in recorded scripting will use the Carelon Medical Benefits Management name. |
| 3. How will third party portals, such as Availity, be impacted? | 3. There will be no change to the way you access these portals. Within the portals, any reference to Carelon Post Acute Solutions will be replaced with the new name. This may take some time to fully complete. |
| 4. Will references to Carelon Post Acute Solutions on health plan websites and other materials be changed? | 4. Yes. While you may continue to see the Carelon Post Acute Solutions company name on health plan websites for some time, these references will be updated over time through scheduled content update cycles.
If your office includes the Carelon Post Acute Solutions name in any materials or web properties, we encourage you to update them to Carelon Medical Benefits Management during your next update cycle. |
| 5. Will information about Carelon Post Acute Solutions continue to be found on the corporate website? | 5. Yes. Post-acute care remains a Carelon solution and will be part of the Carelon Medical Benefits Management portfolio of solutions. You can learn more at www.careloninsights.com |
| 6. Will provider resources, such as key documents and the provider finder, be impacted? | 6. Yes. Our provider resources will continue to be available through our corporate website, and our Provider Resources site. You can access the Provider Resources site here: https://providers.carelonmedicalbenefitsmanagement.com/postacute/. |
| 7. Does this impact provider agreements with Carelon PAS? Will I need to sign a new agreement? | 7. No. There is no impact to provider agreements, and you do not need to sign a new agreement regardless of whether your current contract is with myNexus or Carelon Post Acute Solutions. |
| 8. Do I need to complete credentialing again through Carelon MBM? | 8. No. Providers will not need to re-credential until their normal credentialing cycle. |
| 9. Will my claims be impacted? | 9. No. Claims are not impacted. Payer IDs will remain the same. |
| 10. Will I need to update my W-9? | 10. Providers may need to update their W-9. If you need an updated Carelon MBM W-9, please contact the Carelon Provider Relations department at HHprovider_relations@carelon.com |
Carelon Post Acute Solutions
105 Westwood Place | Suite 400 | Brentwood, Tennessee 37027
Provider call center phone: 844-411-9622
Contact us | Privacy policy | Terms of use
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 Medical Benefits Management 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 following individuals at 866-828-0337 or by email: Joe Thomas, Chief Information Security Officer, or Pamela Hursh, Privacy Officer.