Provider Information

Information for Physicians/Providers

Below you will find important updates and tools that will support you in caring for your CarePlus patients and make doing business with CarePlus easier. The links on the left-hand panel provide access to important forms and manuals. Our resource library contains many of the most-used forms.

COVID-19 Public Health Emergency

Based on current COVID-19 trends, the U.S. Department of Health and Human Services has planned for the federal Public Health Emergency (PHE) for COVID-19 to expire on May 11, 2023. In support of the PHE ending, CarePlus has been updating its COVID-19 policies accordingly. For the latest updates, please visit: Coronavirus Information and Resources for Healthcare Providers - CarePlus.

From all of us at CarePlus, we extend a heartfelt thank you for everything you have done for our members and for the country as we navigated this pandemic together.

My Home Doctor – CareNow® telemedicine/telehealth service

For convenient, accessible phone or video chat triage, diagnosis, treatment and prescriptions, you can refer CarePlus-covered patients to CareNow for all covered services except behavioral health.* To access CareNow, CarePlus members can call My Home Doctor at 1-786-220-8860 (local) or 1-800-341-5353 (toll free), 7 days a week, 8 a.m. to 8 p.m., Eastern time. CareNow is for telehealth visits only and not for patients seeking services from a specific provider or network.

*Please refer CarePlus members seeking behavioral health telemedicine/telehealth visits to CarePlus’ website at to access our online, searchable directory. Network providers that offer covered telehealth services will display a practice focus indicator of “Telehealth.”

The Provider Website (PWS)

You can generate authorizations, verify eligibility, and reference diagnosis codes through our PWS. To request access, contact your provider services executive or call the CarePlus Provider Operations inquiry line at 1-866-220-5448, Monday – Friday, 8 a.m. to 5 p.m., Eastern time.

The provider website (PWS) (link opens in new window) 

Update your directory listing

CarePlus members use our provider directories to select and contact physicians and other healthcare providers. Please notify us of any changes to the following, so we can update your listing:

  • Started or stopped accepting new patients
  • Moved to a new street address
  • New phone or fax number
  • New website
  • Change in specialty
  • Name change
  • Other changes that affect appointment availability

To update your information, you can contact your provider services executive by fax at 1-866-449-5668 or call the CarePlus Provider Operations inquiry line at 1-866-220-5448, Monday to Friday, 8 a.m. to 5 p.m., Eastern time. Please provide your contact information so we can easily reach you with any questions.

Note: If your practice is managed by a health system, independent physician association or other practice association (IPA), please report changes to the administrative office of that organization, which will then update your information with CarePlus.

Availity® Essentials (formerly Availity Portal)

Availity Essentials is a secure central gateway to assist with the following no-cost workflow solutions:

  • Real-time eligibility and benefits inquiry
  • Claims submission and inquiries about previous submitted claims
  • Access to electronic remittance advice
  • Authorization request

Get started today by clicking “REGISTER” at (link opens in new window)

Behavioral Health Services

CarePlus contracts with Magellan Healthcare Inc. to manage its network of providers to render substance abuse and mental health counseling and other treatment to our members.* We encourage coordination of care, communication and information exchanges between behavioral health and medical practitioners.

Learn more about Magellan Healthcare Inc., at Magellan Health (link opens in new window) .

* Effective June 1, 2023, the administration and participating provider network for Community Behavioral Health Services and Mental Health Targeted Case Management Services is managed by Carelon Behavioral Health, Inc. (“Carelon”). Please contact Carelon at 1-833-227-3757 or visit Carelon Behavioral Health (link opens in new window) .

Contracting with CarePlus

Physicians and other healthcare providers can request to join the CarePlus network of providers by faxing a written request to 1-855-659-7966.