Provider contact information

If you are a participating Council for Affordable Quality Healthcare (CAQH) provider, please update your information with CAQH.  If you do not participate with CAQH, please log into ProviderConnect  and select the “Update Demographic Information” option. 

Please note: Updating a Tax ID requires an accompanying W-9 form, which can be accessed and attached through ProviderConnect.

You can also update your information by fax or mail:

Fax number:
866-612-7795 

Mailing address:
Carelon Behavioral Health
c/o Practitioner Maintenance
P.O. Box 989
Latham, NY 12110

If you have general questions about claims, call 800-888-3944. For questions regarding claims submission addresses, please reference the member’s identification card, as the address may vary based on payment location.  

Availity Essentials is the preferred multi-payer portal of choice for submitting the following transactions: 

• Claim submissions (Direct Data Entry Professional and Facility Claims) applications or EDI using the Availity EDI Gateway 
• Eligibility and benefits
• Claim status

For Availity-related questions, please visit the Availity Essentials website  or contact Availity Essentials client service at 800-282-4548, Monday to Friday, 8 a.m. to 8 p.m. Eastern time. 

To obtain information pertaining to your network status, contact our National Provider Services Line at 800-397-1630, Monday to Friday, 8 a.m. to 8 p.m. Eastern time. 

To reach member customer service, call the 800 number on the back of the member’s identification card. You can also call this number for questions about authorization or benefits. 

Register for Payspan to receive direct deposit of provider payments and access remittance data 24/7 by calling 877-331-7154 Monday to Friday, 8 a.m. to 8 p.m. Eastern time, or by visiting the Payspan website . 

Please fax supporting documentation, such as malpractice or insurance cover sheets, to 866-612-7795.

Reports of fraud and abuse, or suspicions thereof, can be made in writing to the following address: 

Carelon Behavioral Health
ATTN:  Special Investigations Unit 
1400 Crossways Blvd, Suite 101 
Chesapeake, VA 23320 

To file an appeal based upon the denial of a payment request, please use the  Provider Claims Based Dispute Resolution Request form and mail to the address given in the PSV or: 
 

Mail to: Provider Dispute Resolution
P.O. Box 1850 Hicksville, NY 11802-1850

Claims appeals request must be submitted in writing to the address given in the PSV or the address above. A complete appeal request must be received within 60 calendar days from the date of the payment determination being appealed, unless the provider agreement or applicable laws or regulations establish a longer filing period.
 

For a more detailed explanation of the complaint and appeal processes please refer to the Carelon Behavioral Health Provider Handbook .

Report all adverse incidents to the clinical care manager with whom you conduct reviews. 

Report all potential situations to the clinical care manager with whom you conduct reviews.