Provider connections

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

Greetings 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.

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 2024 training line up here.
  • Carelon MBM to introduce multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals: Beginning Q3 this year, Carelon will begin to roll out multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals. A pilot group, consisting of MBM user experience group portal users will go first to be followed by a rollout schedule for our existing MBM and post-acute portal users that will be completed in waves Q3 through year end. New portal users who sign up with us starting in Q3 will automatically experience the new multi-factor authentication login process.

    Updates on this rollout will be available on our Provider Connections and post-acute provider sites through project end.

  • 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. New tips posted in this edition include:
    • Reminder: Our Cardiology Solution will be renamed to Cardiovascular Solution effective this July
    • Radiation Oncology update: Our position on usage of radiation therapy to treat benign diseases.
  • 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.

Did you know? Tips and tricks

In this section, we’ve gathered some best practices that will help new and experienced portal users learn and increase knowledge of certain functions, by solution, and globally.

Training

To help you gain new insights and refresher program information, we’re hosting a series of live webinar and Q&A sessions that are designed for providers and office staff who request and/or submit prior authorization.

Portal updates

To provide the best user experience possible, Carelon implements enhancements to our provider portal ongoing. Visit this section to learn about the latest new and improved provider capabilities implemented.

About Carelon

Carelon is a leading specialty benefits management company with more than 30 years of experience. Visit this section to learn how to contact Carelon, how to get involved with our User Experience group and more.