Joining Our Provider Network

Thinking About Joining Our Provider Network? Let’s Build Healthier Communities Together

At Carelon Health of Pennsylvania, we believe great care starts with great providers. We’re proud to connect members with accessible, high-quality behavioral health services—and we’d be happy to explore the opportunity of working together.

Step 1: Check the Open Networks ⌃

Use our Currently Open Network Services | Carelon Health of Pennsylvania to see availability by county and level of care (LOC). If your county or LOC is not listed, the network is currently closed. Please check back frequently as we regularly reassess network needs. 

If the network is open, reach out to our Provider Relations team 

Step 2: Connect with Provider Relations ⌃

Our friendly team is here to help you get started. Email: PAMedicaidProviderRelations@Carelon.com When reaching out, please share: 

  • Provider Name (Facility, Clinic, Group, or Individual) 
  • Contact Name 
  • State, County and Service Location 
  • Type(s) of service you provide 
  • NPI and Tax ID 
Step 3: Complete Contracting ⌃

We make the contracting process quick and straightforward. You’ll be supported through a concierge-style service, with a dedicated team guiding you every step of the way. Providers consistently rate our process highly, with 85% reporting satisfaction with contracting. 

Step 4: Onboarding & Orientation ⌃

Once you’re approved, we’ll get you set up for success. Onboarding connects you with the right tools, resources, and support team. Orientation sessions (offered monthly) give you valuable insights into working within our network so you can feel confident from day one.

Our Strength – Backed by Provider Testimonials

99%

of providers surveyed found their PFC to be professional and courteous.

92%

say their overall experience working with Provider Field Coordinators has been “excellent” or “good”.

85%

rate the usefulness of our educational offerings and materials as “excellent” or “good”.

“PFC is always approachable, responsive, helpful and knowledgeable”

“Our PFC is great to work with – professional, friendly, and takes the time to explain everything”

 

Centralized Resource Hub

Need help after hours or on weekends? Our site Internet is always available at your fingertips—so you can get answers when you need them most.

Here is some of what you’ll find:

Provider Portals – Immediate Access to Key Tools:

Access ProviderConnect, our legacy portal, to submit and check claim status, request inpatient and outpatient authorizations, view and update your provider profile, and more—all available securely.  Provider Connect

 You can also access Essentiels de disponibilité, our preferred provider portal, with single sign-on access to eligibility checks, authorization dashboards, claims submissions, and more—all merging seamlessly with ProviderConnect.  Availity Overview

Comprehensive Provider Manual: 

Browse a detailed, regularly maintained manual covering program overviews, billing and claims guidance, necessary forms, authorization protocols, quality improvement, and provider responsibilities. Provider Manual | Carelon Health of Pennsylvania 

Training Resources & Webinars:

Explore archived webinars, slide decks, practical “how-to” guides for ProviderConnect workflows (like ASAM level-of-care entries and authorization requests), and upcoming training sessions aimed to streamline your daily workflows. Provider Training | Carelon Health of Pennsylvania 

Alerts, Newsletters & Bulletins:

Stay informed on important provider alerts, policy updates, newsletters, and announcements. Easily sign up to receive these via email so you’re always current. Provider Alerts | Carelon Health of Pennsylvania 

Accessible Contact Information:

Find all essential support contacts: Provider Relations, EDI/claims help, the Eligibility Verification System (EVS), the eSupport Help Line, and automated voucher support—so you can reach the right team when needed. Behavioral Health Contacts – Carelon Health of PA | Carelon Health of Pennsylvania

 

Think of the website as your first stop for information—a one-stop hub designed to save you time, simplify processes, and keep you connected.

Ready to Begin? We’re excited to welcome you into a community of providers who make a difference every day. Start today by emailing PAMedicaidProviderRelations@Carelon.com. Together, let’s deliver exceptional care—one member at a time.