About Carelon Medical Benefits Management

About Carelon Medical Benefits Management

Carelon is a leading specialty benefits management company with more than 30 years of experience. Our mission is to help ensure delivery of health care services are more clinically appropriate, safer, and more affordable. We promote the most appropriate use of specialty care services through the application of widely accepted clinical guidelines delivered via an innovative platform of technologies and services.

How does Carelon use the annual provider satisfaction survey results?

Annually, Carelon sends out its provider satisfaction survey in the late fall to determine what we can do to improve your experience with our call center and the Carelon provider portal. Your feedback is extremely important to us, and we use it to make modifications to our approach when making improvements to the provider portal.

Here are some of the improvements Carelon has implemented based on what you, the provider, have told us:

• The Reference Desk is now the Carelon Help Center – easier navigation, more comprehensive tutorials
• Training is now posted in the Carelon provider portal and in our microsites
• Microsites are posted in the Carelon provider portal
• Webinars with Q&A sessions are part of our training
• Increased the number of characters allowed in the Additional Clinical Information text box for cases that do not approve right at case submission on the portal

These are some coming features that our survey responses influenced:

• Letter availability within the provider portal
• Find orders module which allows users to search for orders across programs via order number or member
• Improved communication when there are any Carelon service disruptions

Carelon would like to thank those who completed our annual survey this year; you can see how many updates (improvements) we have already made based on your responses. We will be prioritizing initiatives throughout the year, based on your feedback, and continue to improve your Carelon experience.

The survey is not the only way to tell us what you want. We have a dedicated email address that is available all year for your suggestions: .

We look forward to hearing from you!

Our first days as Carelon Medical Benefits Management

Effective March 1, 2023, we introduced our new company name, Carelon Medical Benefits Management. Carelon is a new healthcare services brand dedicated to solving the industry’s most complex challenges, with the benefit of no changes to the effective services and staff you’ve come to rely on.

Reminders:

• This was a name change only and it did not impact the services Carelon offers or the way we work with providers.
• No changes have been made to the way you submit a case or the contact information you use for checking case status.
• Our provider portal address did not change; all providers continue to have access to providerportal.com, unless required by the health plan to go through the single sign on. Navigating to it from our corporate website is also easy via our new URL: www.careloninsights.com/sign-in-or-register.
• Our corporate website address did The new URL is www.carelon.com, which we encourage you to bookmark for easy reference, along with www.carelon.com/capabilities/medical-benefits-management.
• Our former site link has been redirected to our new URL.
• Our corporate clinical appropriateness guidelines and cancer treatment pathways website address has changed. The new URL is carelonmedicalbenefitsmanagement.com. Our former site link has been redirected to our new URL.
• Our provider microsites did You can locate the new links in the Tips and tricks section of this blog. The former site links have been redirected to the new URLs.
• No changes have been made to the way you access third party portals, such as Availity.
• No inbound phone numbers have been changed. All references to our company name in recorded scripting have been updated to Carelon.

If you have any questions, please connect as needed: WebCustomerService@carelon.com. Please see below for a list of frequently asked questions (FAQs).

Provider brand transition FAQs

Employee spotlight – Meet Stefanie

Senior UX Researcher and Designer

Stefanie has been a researcher with Carelon for six years. Previously, she worked with Northwestern Memorial Hospital as a CT technologist and has always been an artist. As a UX researcher and designer, Stefanie works with customers and end users to better understand their unique concerns so Carelon can deliver the best user experience possible.

“After we wrap up a research study with participants, a big part of my job is making recommendations for potential improvements of our programs and portal. It excites me to know that our participants, through objective feedback, take part in future enhancements to our products. The User Experience team gold standard is to learn more about the people using our systems and what motivates them. This is why we take the time to see what leads the user through their journey and really listen to what they are telling us.”

When Stefanie is not working, Stefanie enjoys laughing with friends and family, creating art, visiting different cities, being in nature, and streaming sci-fi, British drama & suspense.

“I love learning user behaviors and perceptions in our applications through research. There’s a lot of practice and joy in listening and talking with people. I use research methods that include in-person observations, surveys, and remote feedback sessions. I guess you could say I’m an explorer at home and at work.”

Stefanie can often be quoted saying “No matter what happens, something good is about to happen. No matter what.”