Provider Information

Information for Providers

We truly value our relationships with our providers. If you are one of our providers, this section offers you 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) 

Contracting with CarePlus

Health care providers may request to join CarePlus by contacting the CarePlus Provider Operations department at 1-866-220-5448, Monday through Friday, from 8 a.m. to 4 p.m. Eastern time.

Practice and facility information changes

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

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

In order for CarePlus to maintain accurate provider directories, health care providers need to notify CarePlus of changes to their 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 health care providers. Beneficiaries and/or their representatives/caregivers rely on the provider directory to make informed decisions regarding their health care 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 Operations Help Line at 1-866-220-5448, Monday through Friday, 8 a.m. to 4 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 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.”

Change Healthcare™

Change Healthcare is another tool that can help health care providers reduce costs and administrative tasks. It offers:

  • Real-time eligibility and benefits inquiries
  • Claims submission and inquiries on 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).

Beacon Health Options

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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