Find the right department

Network Operations and Provider Relations share this fax.

Behavioral Health, Pennsylvania Medicaid – Outpatient Authorizations. Family-based fax 855-439-2442; Clinical – SCA fax 855-439-2446.

Behavioral Health, Pennsylvania Medicaid – Peer Office/Grievances.

PA HealthChoices BH-MCO for Armstrong, Beaver, Butler, Crawford, Fayette, Indiana, Lawrence, Mercer, Venango, Washington and Westmoreland counties. Customer service 24/7; out-of-network providers call to initiate the process.

Page contact for Carelon's Connecticut programs (Voluntary Care Management, Integrated Family Care and Support, Intensive Care Coordination). Email CTChildAndFamily@carelon.com (VCM) and CTIFCSGeneral@carelon.com (IFCS) are also listed.

Plan's provider relations department, listed by Carelon for Fallon members' non-behavioral topics (PCP changes, referrals, plan appeals, benefits). EDI coordinators: same number, option 6. Not a Carelon line.

Page: general questions about claims. For claims submission addresses, use the member ID card because the address varies by payment location.

Carelon’s current Illinois page identifies this as its 24-hour Humana access line and publishes the program provider-relations email separately. The currently designated 2026 Humana Dual Fully Integrated HMO D-SNP manual also identifies this phone as automated eligibility verification / IVR. These hours describe access, not a promise of a continuously staffed provider-relations desk. Claim disputes, appeals and prior-authorization submission channels are distinct and are not assigned to this record.

Page: for the employee assistance program, contact the Kaiser Permanente National EAP Provider Line.

Page lists customer service and provider relations (credentialing and contracting) for the Wellpoint-related Massachusetts section at the same number.

Authorization by portal, phone or fax; clinical staff 24/7 for urgent. Old Beacon numbers discontinued.

Listed on a Carelon site-change form.

Page block: Carelon Behavioral Health, 500 Unicorn Park Drive, Woburn, MA, followed by Amida Care plan contact details (Amida Care 646-786-1800). Verify plan assignment.

Page block: Carelon contact followed by Independent Health plan contact details (member services 716-631-8701 / 800-501-3439).

Page block: Carelon contact followed by VillageCareMAX details (member services 800-469-6292).

Page: Carelon automated faxback service for NC Medicaid Direct.

Page: NC Medicaid Provider Services, NC Public Sector Provider Service Department and Carelon customer service for remaining Carelon-managed NC Medicaid Direct authorizations (most BH authorizations for these beneficiaries now go to LME/MCOs, except Cumberland Hospital and CDSA services). Authorizations via ProviderConnect.

Page: Carelon has 60 days to review a complete request; include begin and end dates of the period to review.

Page: CAQH participants update information in CAQH; non-CAQH providers use ProviderConnect 'Update Demographic Information' or this fax/mail.

Page: customer service for authorizations, member benefits and eligibility for all lines except Medicare (also 800-878-4445). Medicare: 503-574-8000 or 800-603-2340. Healthcare Service Medical Management: 800-638-0449, option 5.

Page: fax numbers for Providence Health Plan members: BH PA 503-574-8110 and BH CCR 503-574-8192.

Page: provider relations for credentialing/contracting and claims payment questions; National Provider Service Line is 800-397-1630.

Page: Medicare line (also 800-603-2340) for authorizations, member benefits and eligibility.

Page: claims questions for Wellpoint claims; Wellpoint's payer ID is WLPNT. Also lists EnrollSafe electronic claims at 877-882-0384.

Carelon phone line for BCN commercial and BCN Advantage members for Carelon-managed services (cardiology, high-tech radiology, radiation oncology and others per the FAQ). Do not use the Blue Cross commercial/Medicare Plus Blue number for BCN members. FAQ revised September 2026.

Carelon prior authorization and recommended clinical review (RCR) for select outpatient services for some BCBSTX members: Blue Choice PPO, Blue Essentials, Blue Premier, Blue Premier Access, Blue Advantage HMO, MyBlue Health, Blue High Performance Network, TRS and ERS participants. Carelon Provider Portal preferred. Fax is only for physicians/professional providers sending clinical information for existing requests. Capitated IPA/medical group providers follow the IPA's process.

BCBSMA high-tech radiology page: request individual consideration from Carelon before the service is performed — Carelon Medical Benefits Management c/o Appeals Department. Claim appeals go to BCBSMA, not this fax.

Carelon's Contact Center for BCBSMA members whose plans require Carelon review of high-technology radiology; the BCBSMA sleep management page lists the same number for sleep services, and Carelon's BCBSMA genetic testing FAQ lists it for genetic testing. Carelon Provider Portal (providerportal.com) is the online alternative.

Carelon manages cardiology, high-tech radiology, in-lab sleep studies (adult Blue Cross commercial members in certain self-funded groups only), medical oncology (URMBT only) and radiation oncology for Blue Cross and/or BCN. Use this number for Blue Cross commercial and Medicare Plus Blue members; requests must go through the number assigned to the plan so they route correctly. FAQ revised September 2026.

Carelon replaced EviCore for some BCCHP (Illinois Medicaid) prior authorizations for dates of service on or after Aug. 1, 2025: genetic testing, medical oncology, radiation oncology, musculoskeletal (spine, joint, pain procedures), radiology and rehabilitation (PT/OT/speech). Code lists are in BCBSIL government-program prior authorization materials. Source is a July 2025 BCBSIL news notice.

CareFirst genetic testing prior authorization FAQ (older document still posted on Carelon's genetic testing resources page; it uses the former AIM name). CareFirst providers can also start requests in CareFirst Direct's Pre-Auth/Notifications tab. Confirm the program is current for the member.

Independence contact page: Carelon handles precertification for CT/CTA, MRI/MRA, PET, nuclear cardiology, facility-setting sleep studies, CPAP titration, sleep equipment (APAP, BPAP, CPAP) and supplies, the Cardiology Utilization Management Program and the Musculoskeletal Utilization Management Program. Radiation therapy and genetic testing are with eviCore at a different number.

Louisiana Blue Professional Provider Office Manual (June 2026): use Carelon for high-tech imaging, cardiology, genetic testing, musculoskeletal, radiation oncology and sleep management programs; Louisiana Blue does not perform these reviews. Online via the Carelon MBM Provider Portal or iLinkBlue Authorizations tab.

Carelon genetic testing program FAQ for PacificSource: submit test requests via the ProviderPortal or by calling Carelon. FAQ is an older document posted on Carelon's genetic testing resources page; confirm the program still applies to the member's plan.

Carelon Medical Benefits Management post-acute care program site (Brentwood, TN) provider call center. For post-acute (e.g., SNF/IRF/LTACH) reviews where the health plan delegates them to Carelon; confirm the member's plan uses this program.

Premera says Carelon reviews genetic testing, imaging (CT, echocardiography, MRI, MRA, nuclear cardiology, PET), radiation oncology and sleep study/sleep medicine for applicable members. Register with Carelon and submit online or by phone; same number for questions. Prior authorization isn't required for ER services or inpatient hospitalization (see page).

Carelon genetic testing prior authorization for UCare members; also the line for urgent genetic testing requests (response within 72 hours). Portal: providerportal.com. Portal technical help is the separate Carelon support line.

Provider portal support, not a universal prior-authorization phone. Clinical authorization routing depends on the member plan.

Anthem NY medical injectables PA fax (including Medicaid members).

Anthem New York pharmacy information page (CarelonRx PBM). Fax is retail pharmacy PA; medical injectables (including Medicaid members) fax 844-493-9206.

CarelonRx medical injectables PA fax for Healthy Blue Louisiana Medicaid.

Healthy Blue Louisiana pharmacy page: pharmacy department/CarelonRx PA by phone; retail PA fax to CarelonRx; medical injectables fax 844-487-9291. Medicare Part D uses CarelonRx Provider Services.

CarelonRx Pharmacy Help Desk for Healthy Blue SC claims. Pharmacist line, not prescriber PA.

Healthy Blue SC pharmacy page: CarelonRx PA phone; fax the Universal Prior Authorization Request Form: Medications. Medical injectables are handled by CVS/Novologix (844-345-2803, fax 866-494-9927), not CarelonRx.

Medical Injectable Prior Authorization Form fax for Wellpoint DC Medicaid.

Wellpoint District of Columbia works with CarelonRx to administer pharmacy benefits. Fax is for outpatient pharmacy drugs; medical injectables fax 844-487-9294. ePA via CoverMyMeds.

Medical injectables (medical benefit) PA fax for Wellpoint Iowa Medicaid.

Wellpoint Iowa pharmacy department; CarelonRx is the PBM. Fax is retail pharmacy PA; medical injectables (medical benefit) fax 844-512-7026. ePA via CoverMyMeds.

Medical Injectables Prior Authorization form fax for Wellpoint Maryland Medicaid members. Not for retail pharmacy drugs.

Wellpoint Pharmacy department (Wellpoint works with CarelonRx to administer pharmacy benefits). Fax is for outpatient pharmacy drugs; medical injectables use fax 844-490-4873. ePA via CoverMyMeds.