提供者手册

电子商务要求

Effective January 1, 2015, providers in the Carelon network will be expected to electronically conduct all routine transactions, including:

  • 提交索赔
  • 提交授权请求
  • 验证资格查询
  • 提交重新认证申请
  • 提交POMS
  • 电子资金转帐
  • 提供商声明和授权状态检查

New providers with a contract date of July 1, 2014 or later will be expected to comply immediately with this requirement upon joining Carelon.

To conduct these transactions referenced above, Carelon requires providers to utilize the resources detailed in the 电子资源 section of Carelon’s website.  Additional information on E-support Services/ProviderConnect and Electronic Claims can be found here: https://www.carelonbehavioralhealth.com/providers/resources/provider-portals

如果参与提供者未通过电子方式提交索赔,则索赔可能会延迟。 

对此要求有任何疑问或进一步的帮助,请与您的 提供者现场协调员 or call the Carelon Provider Service Line at (800) 397-1630 Monday through Friday, 8 a.m. to 8 p.m. EST.