Information for Physicians and Providers
Find information and resources to help make doing business with CarePlus and caring for your CarePlus patients easier.
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Provider Portals

Please use the multi-payer Availity Essentials™ to:

  • Check patient eligibility. 
  • Review and submit claims. 
  • Review patient benefits. 
  • Submit preauthorization requests.  

Learn more below about Availity.

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Additional Information for Providers

  • Availity® Essentials™

    Availity Essentials is a secure central gateway that lets you:

    • Access electronic remittance advice.
    • Access patient prescription history.
    • Get real-time eligibility and benefits information.
    • Submit and view preauthorization requests.
    • Submit claims and review previously submitted claims.

    Learn more about the benefits of using Availity .

    Get started today

  • Provider Web Services (PWS)

    Through PWS, you can:

    • Get real-time eligibility, prescription and benefits information.
    • Submit and view preauthorization requests.

    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. to 5 p.m., Eastern time.

    Go to PWS

  • Behavioral Health

    CarePlus contracts with Carelon Behavioral Health to manage its network of providers to render 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 Carelon.

  • Telehealth

    For convenient 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), 7 days a week, 8 a.m. to 8 p.m., Eastern time. TTY users can dial 711.

    *Please refer CarePlus members seeking telehealth visits for behavioral health to CarePlus’ Find a Doctor tool to access our searchable directory online. Network providers that offer covered telehealth services will display a practice focus indicator of “Virtual Care - Audio/Visual.”

Update Your Directory Listing

  • CarePlus members use our provider directories to select and contact physicians and other healthcare providers. That’s’ why it’s important that we update your listing as soon as there are changes.

    Please notify us of any of the following changes: 

    • Started or stopped accepting new patients 
    • New street address 
    • New phone or fax number 
    • New website 
    • Change in specialty 
    • Name change 
    • 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 to Friday, 8 a.m. to 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. 

Contracting with CarePlus

Physicians and other healthcare providers can request to join the CarePlus network of providers by completing the Letter of Interest form and faxing it to 1-855-659-7966.

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Last Updated:

01/07/2025