Provider Manual

PROVIDER TRAINING

Carelon provides technical assistance to providers who want to apply to our network and conducts a variety of provider forums and trainings available to already credentialed and contracted providers. Provider forum topics cover Carelon’s Clinical Criteria, claims and billing information, technical assistance, policies and procedures, and other relevant topics. Providers should review our provider newsletter and our website (pa.carelon.com) for training announcements. Also, our Cultural Competency Training. Many past provider trainings are archived on the Provider Training page on our website.

Mandatory Training

All new providers to Carelon are required to complete the New Provider Trainings. Carelon requires that all new providers complete the fraud, waste and abuse training available on the pa.carelon.com internet website upon the completion of the credentialing process. The address is as follows:
pa.carelon.com/fraud-waste-and-abuse.