Provider Information

Information for Providers

We thank you for taking good care of your CarePlus-covered patients and invite you to explore the helpful information on this website.

We have made it more intuitive and have added a resource library, where important forms and manuals can be easily accessed.

Coronavirus Disease 2019 (COVID-19)

CarePlus is committed to supporting you as you care for your patients. We are closely monitoring Coronavirus Disease 2019 (COVID-19). For more information, click here.

Click here(link opens in new window) for the latest updates from the CDC.

For ICD-10 codes related to COVID-19, click here(PDF opens in new window).

My Home Doctor – CareNow® telemedicine/telehealth service

CareNow, a service from My Home Doctor, provides telephone or video chat access to physicians and nurse practitioners/physician assistants who can triage, diagnose, treat, and prescribe medication. You can refer your CarePlus-covered patients requesting a telemedicine/telehealth visit to CareNow for all services (with the exception of behavioral health*). To access CareNow, CarePlus members can call My Home Doctor at 786-220-8860 (local) or 1-800-341-5353 (toll free), 8 a.m. to 8 p.m. Eastern time, seven days a week. This program is not for patients seeking services from a specific provider/network. CareNow is for telemedicine/telehealth visits only.

*Please refer CarePlus members seeking behavioral health telemedicine/telehealth visits to CarePlus’ behavioral health vendor, Magellan Healthcare. Both members and providers can contact Magellan Healthcare at 1-800-424-1760 (toll free number), open 24/7.

The Provider Website (PWS)

The physician/provider website (PWS) is a secure site that allows physicians/providers to generate authorizations, verify eligibility and reference diagnosis codes. If you are interested in requesting access to the PWS, please contact your assigned provider services executive or call the CarePlus provider services queue at 1-866-220-5448, Monday through Friday from 8 a.m. to 5 p.m. Eastern time.

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

Contracting with CarePlus

Physicians and other healthcare providers can request to join CarePlus by calling the CarePlus provider services queue at 1-866-220-5448, Monday through Friday, from 8 a.m. to 5 p.m. Eastern time.

Practice and facility information changes

Have you done any of the following since your last CarePlus update?

  • Started or stopped accepting new patients
  • Moved to a new street address
  • Changed your phone number
  • Changed your fax number
  • Updated your specialty
  • Changed your name
  • Made other changes that affect practitioners’ appointment availability

For CarePlus to maintain accurate provider directories, please notify CarePlus of changes to your information as soon as possible. Provider directories are an important tool used by beneficiaries and/or their representatives/caregivers to select and contact their physicians and other healthcare providers. Beneficiaries and/or their representatives/caregivers rely on the provider directory to make informed decisions regarding their healthcare choices.

If you have changes to your practice/facility information, please provide CarePlus with the updated information immediately using one of the following options:

  • Contact your assigned provider services executive.
  • Fax the information to 1-866-449-5668.
  • Call the CarePlus provider services queue at 1-866-220-5448, Monday through Friday, 8 a.m. to 5 p.m. Eastern time.

When submitting updates, please provide your contact information in case there are questions about the correspondence.

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

Availity® Web Portal

Availity is CarePlus’ secure central gateway to assist healthcare physicians/providers with the following no-cost solutions:

  • Real-time eligibility and benefits inquiry
  • Authorization request submissions
  • To reduce administrative costs and improve your office workflow, get started today by going to Availity.com (link opens in new window) and clicking “REGISTER.”

Change Healthcare™

Change Healthcare is another tool that can help physicians and other healthcare providers reduce costs and administrative tasks. It offers:

  • Real-time eligibility and benefits inquiries
  • Claims submission and inquiries about previously submitted claims
  • Access to electronic remittance advice (enrollment required)

For more information, please see our claims payment page.

To learn more about Change Healthcare, visit its website (link opens in new window).

Magellan Healthcare Inc.

CarePlus contracts with Magellan Healthcare Inc. to provide substance abuse and mental health counseling and treatment to our members. We encourage coordination of care, improved communication and information exchanges between behavioral health and medical practitioners.

To learn more about Magellan Healthcare Inc., please visit its website (link opens in new window) .