This page uses Javascript. Your browser either doesn't support Javascript or you have it turned off. To see this page as it is meant to appear please use a Javascript enabled browser.
Provider Connect Home
Switch Account
Carelon Behavioral Health Home Provider Home Contact Us Log Out

Skip Navigation

Search Case Activity Forms (CAFs)

Required fields are denoted by an asterisk ( ) adjacent to the label.
Provider ID
 
Member ID
 
Authorization # (No spaces or dashes)
 
Claim # (No spaces or dashes)
- -   - -  
Submission From
Submission To
  Calendar   Calendar
(MMDDYYYY)
(MMDDYYYY)

© 2023 Carelon Behavioral Health® ProviderConnect v6.01.00

Return to Carelon Behavioral Health Home | Return to Provider Home | Contact Us | Privacy Statement | Terms and Conditions

URAC URAC NCQA