Provider Information

Information for Providers

We truly value our relationships with our providers. If you are one of our providers, this section will offer you some helpful information. We thank you for taking good care of our members.

We have expanded our website to be more intuitive for our valued providers and have added a resource library, where important forms and manuals can be easily accessed.

The Provider Website (PWS)

The provider website (PWS) is a secure site that allows 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 Operations Help Line at 1-866-220-5448, Monday through Friday from 8 a.m. to 4 p.m.

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

Did Your Information Change?

In order for CarePlus to maintain accurate participating provider directories, health care providers need to notify CarePlus of changes to their information as soon as possible. Keeping information up to date also benefits health care providers’ reimbursement.

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 1-855-659-7966.
  • Call the CarePlus Provider Operations Help Line at 1-866-220-5448, Monday through Friday, 8 a.m. to 4 p.m. Eastern time.

Availity® Web Portal

Availity is CarePlus’ central gateway to assist health care providers with the following no-cost solutions to reduce their administrative costs and the burden on office staff:

  • Real-time eligibility and benefits inquiry
  • Authorization request submission

To register for the Web portal, visit Availity.com and select “Get Started.”

Beacon Health Options (our in-network behavioral health partner)

CarePlus contracts with Beacon Health Options 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 Beacon Health Options, please visit beaconhealthoptions.com (link opens in new window) .

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