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.

Notice of Health Plan Accreditation Survey

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, visit our COVID-19 provider page.

For the latest updates from the CDC, please visit the CDC website(link opens in new window).

ICD-10 codes related to COVID-19, can be viewed in the CDC ICD-10-CM Official Coding Guidelines(PDF opens in new window).

FAQ: New Medicare Advantage HMO-POS benefit plans

For 2021, CarePlus has added two new Medicare Advantage (MA) Health Maintenance Organization Point-Of-Service (HMO-POS) benefit plans:

  • CareOne PLATINUM (HMO-POS) H1019-110, for Space Coast (Brevard and Indian River counties).
  • CareOne PLUS (HMO-POS) H1019-057, for Orlando.

Answers to general questions about these new plans can be found in the FAQ documents below.

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), seven days a week, 8 a.m. – 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’ 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)

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. – 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, 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 – Friday, 8 a.m. – 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 (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 Portal 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
  • Authorization request submissions

Get started today by going to Availity.com (link opens in new window) and clicking “REGISTER.”

Change Healthcare™

To help reduce costs and administrative tasks, this CarePlus partner offers:

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

For more information, please see our claim payment page. Learn more about Change Healthcare, by visiting 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 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., by visiting its website (link opens in new window) .

Contracting with CarePlus

Physicians and other healthcare providers can request to join the CarePlus network of providers by calling the CarePlus Provider Operations inquiry line at 1-866-220-5448, Monday – Friday, 8 a.m. – 5 p.m., Eastern time.