Thank you for your interest in joining the Carelon Behavioral Health’s Provider Network.
As the Administrative Service Organization for Northeast Health Partners RAE (Region 2) joining the Carelon Behavioral Health network will allow you to serve Health First Colorado Members throughout the region.
Carelon Behavioral Health does not discriminate against particular providers for the participation, reimbursement, or indemnification of any provider who is acting within the scope of their license or certification under applicable State law, solely on the basis of that license or certification. Carelon Behavioral Health does not discriminate against particular providers that serve high-risk populations or specialize in conditions that require costly treatment. Should a particular provider be declined to participate in the network, they will receive a written notice of the reason for the decision.
Thank you for your interest in becoming a behavioral health provider with Carelon Behavioral Health.
Carelon Behavioral Health credentials individual practitioners and facilities. Groups must have a valid OBH license to be credentialed as a facility; otherwise we will credential individual practitioners within your group. Please send us the following information for each practitioner and facility that would like to be credentialed with us.
If you are a facility, please send us the above listed information and a roster of your providers.
We will review your information and contact you with next steps.
Thank you for your interest in becoming a PCP with Carelon Behavioral Health.
We offer contracts to any willing provider who meets all requirements to service Medicaid Members as a Primary Care Provider and Medical Home in the ACC Program, this includes:
- Be enrolled as a provider in the Colorado Medicaid program
- Be either:
- Certified by the state as provider in the Medicaid and CHP+ Medical Homes for Children program
- Individual physician, advanced practice nurse or physician assistant with a focus on primary care, general practice, internal medicine, family medicine, pediatrics, geriatrics, or obstetrics and gynecology, or is a qualified CMHC or HIV/infectious disease practitioner or
- A federally qualified Health Center (FQHC) or Rural Health Clinic (RHC)
- Be licensed as a MD, DO or NP provider by the Colorado Medical Board of Nursing to practice in the state of Colorado;
- Act as the dedicated source of primary care for members and be capable of delivering the majority of the Member’s comprehensive primary, preventive and sick medical care; and
- Demonstrate commitment to the following principles of the Medial Home model as amended by the state.
For consideration, please send us the following information for the PCP that would like to be contracted with us:
- PCP Name
- NPI#
- Tax ID
- Medicaid Provider Location ID (aka Billing ID) per service location
- Contracting Point of Contact
- Name, telephone number and email address
- Other Points of Contact, if appropriate
You may send via email coproviderrelations@carelon.com or
fax 719-538-1433.