Portal updates

Reminder: Carelon MBM will soon introduce multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals

Beginning late Q3 this year, Carelon Medical Benefits Management (MBM) 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 late Q3 through year end. New portal users who sign up with us starting in late Q3 will automatically experience the new multi-factor authentication login process.

What is multi-factor authentication (MFA)?

Multi-factor authentication (MFA) is a multi-step login process that requires system users to enter their username and password followed by additional information such as a code sent to their email or phone. In some cases, the additional authentication step may involve answering a secret question that’s been set up ahead of logging in.  Another name that is commonly used for this type of authentication is two factor authentication or 2FA.

Why is MFA important?

Companies commonly use MFA authentication today to protect their own systems, but also to protect those using their systems. Requiring MFA helps protect all against security issues such as compromised login information and phishing attempts. A phishing attempt is an email that tries to obtain confidential information like credit card numbers, user names or passwords.

How can I stay informed of the rollout schedule and additional information?

Check our Provider Connection Portal updates blog page and our post-acute provider Welcome page regularly for the latest information and important dates tied to our MFA rollout. FAQs will be shared in conjunction with the go live date. AQs will be shared in conjunction with the go live date.

Reminder: Use the Carelon provider portal for Home Health, DMEPOS, PAC-IM, SDoH and Wound Care providers to submit prior authorization requests*

Our Carelon provider portal is the quickest and most efficient way to request authorization, provides real-time processing and updates, plus access to archive authorizations should you need to reference them.

Not yet registered? Follow our easy to reference Getting started guide available here or below.

Before you begin the registration process, be aware of the items below:

• Each person in your office who will be using the portal should register their own account. Users should not share portal accounts.
• For providers, you will need to enter the 10-digit NPI.
• For providers only, you will also need to enter your Tax ID.
• You will need to provide your preferred business email address. (No duplicates allowed)
• You will need to provide your preferred business phone number and fax number.

To register

• ‘Accept’ Agree to Terms.
• Click ‘Begin’ to start.
• Click the “Provider Type” dropdown and select your provider type.
• For Providers – Enter your organization’s 10-digit NPI in the “Provider NPI” field. The portal displays providers that match your entry.
• If you cannot find your organization, you will need to call Carelon @ 1-844-411-9622 option 4 for assistance.
• Select your organization.
• Complete the other fields on the page then click Continue and Submit button.

Additional information on our registration process can be found here.

Update to Carelon MBM provider portal ‘check order status’ enhancement implemented

In our recent Carelon Medical Benefits Management (MBM) provider portal release, we implemented an enhancement to our ‘check order status’ functionality to benefit all portal users and save them time.

Prior to the release, the provider portal “check order status” module required a user to select a health plan and Carelon solution prior to searching for a member’s order ID. The portal then displayed the member’s requests for just the selected solution.

The enhancement implemented removed the requirement to select the health plan or solutions prior to pulling up the member’s cases across all solutions. Portal users should now use the newer, more efficient Order Search module, which includes letters.

Please note: The retirement of the former Check Order Status module has been postponed and will now be effective as of August 26^th.

Carelon Medical Benefits Management provider portal branding change

Last year, we introduced our new company name, Carelon Medical Benefits Management (MBM). Carelon is our multi-faceted healthcare services brand dedicated to solving the industry’s most complex challenges.

As a follow up to this rebranding, our former ProviderPortal name has been changed to Carelon MBM provider portal or in some instances, simply provider portal. This is a name appearance change only and does not impact any functional changes to the portal.

If you / your office maintains any documents using our provider portal name with the former branding, please update it at your next opportunity.

MBM provider portal release highlights

You asked for it, we delivered. The following enhancements were implemented as part of our April and May 2024 MBM provider portal releases:

New search updated introduced in our May release

For portal users who need to search for orders by ACMP#, it is now included as search criteria in the Order Search module.

On June 1, portal users will see a message within the Check Order Status module stating it will be retired effective July 1.  Users may continue to search for orders using the newer, more efficient Order Search module, which includes letters.

Home page enhancements implemented

The portal home page has been streamlined to display the user’s name and icons in the right-hand corner of the header.

MBM provider portal ‘Reset your password’ page updated and simplified

For your convenience, we updated and simplified our ‘Reset your password’ page in our recent MBM provider portal December release.

Improvements applied include reduced steps to get you through the process quickly and more concise instructions provided.

The simplified Reset Your Password page will be displayed to portal users in the following scenarios.

1. After user logs in if their password has expired since last login.
2. User clicks on Change Password button in Manage User Profile.
3. User clicks on Reset your password link in Password Reset email sent by an administrator.

When should I fax or upload documents to Carelon?

Did you know that when submitting a case, the Carelon Medical Benefits Management provider portal will let you know when you need to upload additional documents? Following the guidance throughout the provider portal and answering the clinical questions accurately and completely is the most efficient method of getting your case reviewed as quickly as possible. Carelon has designed the clinical questions in a very deliberate manner, intended to gather only relevant information that will allow us to adjudicate the request appropriately. Limiting clinical document uploads to only those situations where they are needed helps to ensure that only the minimum amount of information necessary to perform a service is requested.

If your case does not get approved right on the provider portal, there is an option to type in relevant clinical information in the Additional Information textbox when the case is submitted. The character limit on this textbox has been expanded for most of our programs (most recently for Radiology).

When additional clinical documents are requested, you will have an option to upload your documents at case submission. It is best practice to identify the pertinent information in the patient’s chart for the requested service, and only upload those specific pages on the portal. When Carelon requests documents, it is always better to upload than to fax. When documents are faxed, there can be delays in the documentation getting attached to the case. We know documentation needs can be confusing, so let the provider portal be your guide.