Join the Network

Getting Started In Maryland

Become a participating behavioral health provider for Maryland Medicaid.

Step 1:

  • To register for a community-based behavioral health license in Maryland, you can complete and submit an application to the Maryland Department of Health’s Behavioral Health Administration (BHA). 
  • Once Licensed by BHA, obtain a distinct NPI.
  • Submit a new provider application in ePREP to enroll in Maryland Medicaid.

Please note: Providers may not render services until they are enrolled in Maryland Medicaid

Step 2:

Find your Carelon ID number.

  • Your Carelon ID number will be emailed, faxed, or mailed to your address of record after registering with ePREP.
  • If you are not the primary user, please complete and submit an Account Request Form (ARF).

Step 3:

  • Use your Carelon user ID number to register in ProviderConnect. If you do not have a copy of that information, you can obtain your login credentials by calling the customer service EDI team at 1-800-888-1965 (Press 1 for English, then 3 for Provider, then 7 for EDI).
  • Check out our instructional video on Registering for ProviderConnect and ProviderConnect User Guide for additional support.

Step 4:

Step 5:

  • Once registered in ProviderConnect and Availity Essentials, create your single sign-on access (SSO) within Availity. This will link the two systems so you can log in to Availity directly as your one-stop shop.
  • Learn how to Create Your Single Sign On with this step-by-step video.

Step 6:

Electronic Provider Revalidation and Enrollment Portal (ePREP) 

The state of Maryland has implemented the Electronic Provider Revalidation and Enrollment Portal (ePREP). This resource enables online provider enrollment, re-enrollment, revalidation, information updates, and demographic changes. Visit Maryland Medicaid’s ePREP portal to create a user profile or log in to an existing account. After enrollment at Maryland Medicaid, register with Carelon using ProviderConnect.  

ePREP Provider Portal

Maryland Medicaid enrollment and validation system

Maryland ePREP forms

All Maryland Medicaid providers must sign the Provider Agreement in ePREP at enrollment and revalidation.

ProviderConnect

Carelon’s Provider Portal

ProviderConnect

ProviderConnect is Carelon’s secure, password-protected portal where participating providers conduct certain online activities directly with Carelon 24 hours a day, seven days a week (excluding scheduled maintenance and unforeseen systems issues). ProviderConnect allows you to check claims status, check member eligibility, request inpatient and outpatient authorizations and more.

Register or log in:

ProviderConnect

Training resources for ProviderConnect 

Access Carelon tools effectively with our Get Started Guide: a step-by-step resource for setting up your Carelon accounts, accessing authorizations, and claims. 

ProviderConnect User Guide

An overview of ProviderConnect

Authorizations in ProviderConnect

Notice of new access requirement for provider portals

Multi-factor authentication (MFA) setup is now required for provider portal access. All users of ProviderConnect and eServices must register for MFA.  

Please note: User account credentials cannot be shared. If your organization needs additional accounts, please see use the ProviderConnect online services account request form. 

MFA resources:

For questions or assistance with MFA setup, please email us at:
MFA-ProviderSupport@carelon.com. 

Availity Essentials

Availity Essentials (“Availity”) is a secure, self-service, multi-payer space and our preferred choice for: 

  • Direct data entry claim submissions 
  • EDI claims 
  • Checking eligibility and benefits   
  • And more 

Please note: the Maryland Public Behavioral Health System payer tile in Availity looks like the below:

Register or log in:

Availity Essentials

New to Availity? 

Access Carelon tools effectively with our Get Started Guide: a step-by-step resource for setting up your Carelon accounts, accessing authorizations, and claims. 

Check out the resources below to find training and education resources to get you started. 

Once you are able to login, Availity offers step-by-step instructions and screenshots for anything and everything a provider can do on Availity Essentials. To access:  

  • Login to Availity Essentials.  
  • Select the Help & Training drop down in the top navigation bar.  
  • Select Find Help.  
  • Choose a topic or search using the search bar. 

Non-Medicaid Providers

Coming soon

Gambling Center of Excellence

The Maryland Department of Health (MDH), in collaboration with Carelon Behavioral Health of Maryland and the Center of Excellence on Problem Gambling, has worked to open access for individuals and their loved ones to receive gambling services. 

Effective 2018, Maryland residents have access to reimbursement for problem gambling services. These services include assessments, individual therapy, and group therapy for individuals with gambling disorders and their loved ones. Residents can receive these services through outpatient community Mental Health and Substance Use Disorder programs or private practitioners. 

Providers

Visit the Gambling Center of Excellence website to join the network as a provider

Participants

Learn more about gambling resources for participants