Provider connections

Radiology providers: Have you registered on OptiNet? Click here for the article and scroll to the radiology program.

Happy fall from our Carelon Medical Benefits Management (MBM) teams. We thank you for all you do! Welcome to Provider Connections, our news blog for prior authorization staff and provider portal users. Visit our site frequently to learn about the best ways to use the Carelon Medical Benefits Management (MBM) provider portal and how to reduce unnecessary calls by using all available features. Our goal is to provide tips and tricks to make your day easier and more efficient.

This site includes educational resources that will help enhance your knowledge of the portal, provide a first look at recent portal enhancements and supply you with program-specific tips you and your office staff can put to everyday use.

We appreciate your partnership and hope you find this information valuable as we continue our work together to ensure health plan members receive quality, affordable specialty care that’s driven by rigorous clinical evidence.

To submit a new case for prior authorization, or check on an existing one, sign in to our Carelon Medical Benefits Management provider portal: providerportal.com. Not registered yet? Sign up here: register.providerportal.com. External submission scenarios: If you currently use a dedicated health plan/payer portal to submit prior authorization requests, please continue to use that portal to submit requests to Carelon Medical Benefits Management.

Don’t miss our latest blog updates:

• Be sure to attend one of our complimentary training webinars to stay on top of Carelon MBM program news and updates. You’ll gain new insights and refresher program information all at the same time. You can find our remaining 2024 training line up here, and get an early start on next year’s training by checking out our 2025 offerings posted.
• Reminder: Earlier this month, Carelon introduced multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals. New portal users who sign up with us moving forward will automatically experience the new multi-factor authentication login process.
• Visit the Tips and Tricks section of our blog to learn the latest about our MBM solutions including important Resource page updates you may have missed.
• Our latest MBM provider portal updates
• Post-acute providers / portal users can find our latest program updates and helpful resources here.
• Reminder: Help us to protect patient PHI and reduce errors by selecting the correct member
• How you can join the Carelon user experience group. Learn more here or sign up today.

You can direct any questions or topic recommendations by sending an email to:  WebCustomerService@carelon.com.

Privacy reminder:

Help us protect patient PHI: When submitting a case on the provider portal, be sure to select and verify the correct office demographic information for the ordering provider (office address & fax number) and servicing provider (office address) as letters with patient PHI are sent.

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:

• WebCustomerService@carelon.com