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Pkirsch1

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Hi,
A letter from Anthem states THE SERVICING PROVIDER WASNT PAR FOR THE DOS AND SHOULDNT BE SUBMITTING CLAIMS UNDER PAR GROUP TAX.

Who do I contact regarding this? The claim is not on file, it is not a denial, do I contact credentialing? This provider is credentialed.

Thank you,
Pam
 
Yes, you would need to contact someone at Aetna, either in their credentialing or network services department. There would usually be some kind of contact information on the letter you received - if so, I would start with that.
 
thomas7331 said:
Yes, you would need to contact someone at Aetna, either in their credentialing or network services department. There would usually be some kind of contact information on the letter you received - if so, I would start with that.
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Thank you Thomas, I did call CAQH and the provider is credentialed with Anthem. I'm in CT, I was told to contact Carelon to see if the provider is credentialed with them. Would that be right?

I really appreciate your help!
 
Google tells me Carelon and Anthem are affiliated and possibly part of the same parent company?? Regardless, many insurances do outsource credentialing, or part of credentialing like specific specialties. If Anthem is telling you they outsource credentialing to Carelon, then that is who you would need to contact.
 
csperoni said:
Google tells me Carelon and Anthem are affiliated and possibly part of the same parent company?? Regardless, many insurances do outsource credentialing, or part of credentialing like specific specialties. If Anthem is telling you they outsource credentialing to Carelon, then that is who you would need to contact.
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Don't get me started on all these name changes for (IMO) no real reason.

I understand if companies change names due to a merger or something like that. Some of these changes seem like just rebranding.

If only these companies could focus on improving services rather than just rebranding. New names, same BS. (My personal opinion and not an official position of my employer or AAPC) ;)

Carelon is the former AIM Specialty Health. They changed names to Carelon not long after Anthem's name changed to Elevance.

(I don't know if there's any ownership affiliation with the Blues and AIM/Carelon or not. We have other payers who use AIM/Carelon too.)
 
At least in Missouri, Anthem (Elevance) has merged with Carelon (Beacon) for their mental health. And it is a total cluster. In my experience with Beacon (Carelon), credentialing takes about 6 months, so don't get in a hurry.
 
Pkirsch1 said:
Hi,
A letter from Anthem states THE SERVICING PROVIDER WASNT PAR FOR THE DOS AND SHOULDNT BE SUBMITTING CLAIMS UNDER PAR GROUP TAX.

Who do I contact regarding this? The claim is not on file, it is not a denial, do I contact credentialing? This provider is credentialed.

Thank you,
Pam
Click to expand...
Hi Pam,
I have experienced the same issue in Connecticut. Just curious if you were ever able to find a solution to this. Thanks!
 
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