![]() ![]() Learn about the latest clinical engine enhancements we’ve implemented for our Genetic Testing solution! Visit the Tips and tricks section of our site!.Gain new insights and refresher program information: Find upcoming webinar opportunities here!.External submission scenarios: If you currently use a dedicated health plan/payer portal to submit prior authorization requests, please continue to use that portal to submit requests to Carelon Medical Benefits Management. To submit a new case for prior authorization, or check on an existing one, sign in to our Carelon Medical Benefits Management provider portal:. We appreciate your partnership and hope you find this information valuable as we continue our work together to ensure care that is appropriate, safe, and affordable. This site includes educational resources that will help enhance your knowledge of the portal, along with tips specific to our solutions, such as rehabilitation, medical oncology, and radiology, for example. Our goal is to provide tips and tricks to make your day easier and more efficient. ![]() Visit our site frequently to learn about the best ways to use the Carelon Medical Benefits Management (MBM) provider portal, and how to reduce unnecessary calls by using all available features. Happy mid-summer from our Carelon teams! Welcome to Provider Connections, our news blog for prior authorization staff. Radiology providers: Have you registered on OptiNet? Click here for the article and scroll to the radiology program. For simplicity, we will hereafter use, “site of care”.As of March 1, 2023, AIM Specialty Health is now Carelon Medical Benefits Management! Click here to read the article. * In some plans “level of care” or another term such as “setting” or “place of service” may be the term used in benefit plans, provider contracts or other materials instead of or in addition to “site of service” and in some plans, these terms may be used interchangeably. Providers become eligible alternate site of care providers one business day after registering in Opti Net. Select “Access Your Opti Net Registration” (on the left sidebar) to launch the quick Opti Net registration processįor your convenience, all saved information will be retained for future sessions to allow flexibility in returning to finish the submission process.Log in to our provider portal (registration required).When you contact us to order imaging studies, we offer the information we collected in Opti Net to help locate clinically appropriate, convenient, and cost-effective alternate imaging study facilities for your patients. How Do We Use the Information We Collect with Opti Net? Additionally, “provider type” has now been added to Opti Net to capture the site’s status as a free-standing imaging facility, physician group, or hospital. Providers register sites within Opti Net to become eligible alternate site of care providers. Providers will be asked to submit information in areas such as staffing credentials and certifications for both technologists and physicians interpreting images, equipment specifications, quality assurance programs and policies, and accreditation statuses. Opti Net ®, which is available in the Carelon Medical Benefits Management provider portal, is a proprietary, multifaceted program designed to collect service and capability information on outpatient imaging providers. ![]()
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