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

30-Day Authorization Initiative  | Effective May 16, 2025

Notice: The notice regarding the 30-day authorization initiative is available here.

Trainings: Trainings on this process will be available on or after April 18, 2025. Carelon will email blast all provider portal users once the training link is available.

30 Day Authorization Initiative for Home Health providers: On May 16, 2025, Carelon will introduce a standardized 30-day review period for all home health authorizations. For access to the provider orientation, click 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.