Providers Home | Carelon Health of Pennsylvania

ATTENTION PROVIDERS: The contact information below is for Pennsylvania Medicaid Behavioral health only. Please refer to the information on the back of the member’s insurance card for contact information if outside of Pennsylvania Medicaid Behavioral Health.

Provider Orientation

Carelon of PA is committed to helping providers succeed in serving our members. As part of this commitment, orientation sessions are offered to help educate providers and staff on the resources and information available on our PA website. Knowing what resources are accessible to you is important to us, and we understand that this can be difficult to navigate without a guiding hand.

Orientation sessions are open to all providers, whether newly credentialed or already established in our network. Participation is encouraged for anyone who feels they would benefit from this knowledge. Sessions offer a good opportunity for new staff to orient themselves to Carelon and our processes. If you are interested in attending a provider orientation session, please contact your Provider Relations Representative.

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Provider Portals (Claims Submission and More!)

Availity

Availity Essentials is Carelon’s new preferred provider portal! Through Availity, providers are able to submit claims, check member eligibility, access the authorization dashboard and more, all through a single sign-on linked to our legacy provider portal called ProviderConnect. As the capabilities are expanding through Availity Essentials, ProviderConnect remains available.

ProviderConnect

ProviderConnect is our legacy portal, it also allows you to submit and check claims status, check member eligibility, update your provider profile, request inpatient and outpatient authorizations and more. ProviderConnect is easy to use, secure and available 24/7.

ProviderConnect Information and Resources

To better serve HealthChoices members, Carelon remains committed to providing education, information, and resources for providers.

Our comprehensive Provider Manual provides a quick reference for most questions including a detailed program overview, claim and billing information, and important forms providers use on a daily basis. Here you will be able to find details on each departmental area managed by within the Carelon engagement center.

For network-specific information regarding claims and billing, provider enrollment, quality management and other materials that providers and staff may find very useful, visit the Provider Information Center.

Once again, welcome to Carelon Health of Pennsylvania (A Behavioral HealthChoices MCO) Provider Online Services. If you have any questions, please don’t hesitate to contact our team at 1-877-615-8503 or by email at pawebmaster@carelon.com for assistance.

Carelon mailing address (PA Medicaid Behavioral Health Only):
Carelon
P.O. Box 1840
Cranberry Township, PA 16066-1840