Cambia

Carelon Post-Acute Care | Home Health

Carelon Medical Benefits Management is excited to announce the partnership with Cambia Health Solutions, LLC for management of home health services for Medicare Advantage members in the states of Idaho, Oregon, Utah, and Washington effective January 1st, 2024.

Please find important announcements, documents, and forms listed below for each of these delegations:

Current announcements

January 1, 2024 | Delegation information

Delegation:
Effective January 1, 2024, Carelon will begin management of Cambia Medicare Advantage home health services in the states of Idaho, Oregon, Utah, and Washington. Delegated services include Utilization Management.

Notice: The delegation notice and orientation letter mailed to providers is available below by market:
Regence notice
Asuris notice

Training sessions:
Registration for provider training sessions can be found online here.

Contact:
Email us with questions related to this delegation.

Provider information form

Please complete the “Agency Information Form” if your agency’s information needs to be added to the Carelon system after 1/1/24. The form is found online here.

Authorization program materials

In-scope plans:
In-Scope Plan List: The list of in-scope Cambia plans for the Carelon delegation.

Authorization requests:
Carelon provider portal: Carelon encourages providers to utilize the online provider portal to submit authorization requests. The provider portal can be found online here.

Initial authorization request form: Fax form to use for initial authorization requests if needed.
Re-authorization request form: Fax form to use for re-authorization requests if needed.

Fax confirmation form: Online Form providers use to confirm their fax numbers for authorization requests.