Inquiries regarding Carelon’ information security and privacy policies, procedures or activities may be directed to the Privacy Team through email. Carelon Post Acute Solutions employs industry standard information security systems including, but not limited to: Unified Threat Management (UTM), Vulnerability Threat Management (VTM), Data Loss Prevention (DLP), and Security Information and Event Management (SIEM), Email Encryption, and Secure Sockets Layer (SSL) certificates. OCR has enforcement authority with respect to health programs and activities that receive Federal financial assistance from the Department of Health and Human Services (HHS) or are administered by HHS or any entity established under Title I of the Affordable Care Act or its amendments. (age), or Section 504 of the Rehabilitation Act of 1973, 29 USC § 794 – PDF (disability), under any health program or activity, any part of which is receiving Federal financial assistance, or under any program or activity that is administered by an Executive Agency or any entity established under Title I of the Affordable Care Act or its amendments. – PDF (sex), the Age Discrimination Act of 1975, 42 USC § 6101 et seq. – PDF (race, color, national origin, sex, age, sexual orientation, gender identity, and disability), Title IX of the Education Amendments of 1972, 20 USC § 1681 et seq. Please contact the Carelon provider network team with any questions by email or:Īn individual shall not be excluded from participation in, be denied the benefits of, or be subjected to discrimination on the grounds prohibited under Title VI of the Civil Rights Act of 1964, 42 USC § 2000d et seq. A synopsis of the criteria is available to Providers and Members on request and free of charge by calling Carelon at 84 or by email. Carelon evaluates provider qualifications based on the Utilization Review Accreditation Commission (URAC) requirements.ĭownload a copy of the application packet here:Ĭredentialing application and criteria packet Contact usĬarelon utilizes CMS National and Local Coverage Determinations (NCD and LCDs) when applicable, or Anthem medical policies and clinical Utilization Management guidelines to facilitate the appropriate evaluation of medical necessity by including assessment of the member throughout the continuum of care. Please download the Credentialing application found below, complete, and return to our Credentialing team by email or via fax at (615) 724-7468. If Carelon Post Acute Solutions accepts your provider contracting application, you will need to complete the appropriate credentialing application. Answer: The timely filing requirement for primary or secondary claims is one calendar year (12 months) from the date of service. Billing and Remittance Indiana Medicaid Indiana Medicaid for Providers Business Transactions Billing and Remittance As a Medicaid provider, what's the best way for you to submit claims to the Indiana Health Coverage Programs (IHCP) It's a big topic and an important one. (Applicable for Home Health program only) Carelon Post Acute Solutions credentialing Please click one of the links below to gain access to the relevant information. Anthem program information is available for Home Health, PAC-IM, SDoH, and Wound Care Connect.
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