Insurance Companies
Carelon Behavioral Health., Inc.Complaints
This profile includes complaints for Carelon Behavioral Health., Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see
Customer Complaints Summary
- 75 total complaints in the last 3 years.
- 34 complaints closed in the last 12 months.
If you've experienced an issue
Submit a ComplaintThe complaint text that is displayed might not represent all complaints filed with BBB. Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business.
Initial Complaint
Date:05/22/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am a provider that filed claims with this insurance company in December. The claims have been on file since December and even though I have called numerous times to check on the progress, I keep being told to wait longer. When I ask to speak with a supervisor the representative tells me they will call me back. No one calls me back. It has been 5 months with no progress and no answers from representatives.
Business Response
Date: 05/28/2025
Attached is Carelons response to 23365223.
Thank you,Initial Complaint
Date:05/02/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
As a mental health provider I billed the clients insurance Carelon after calling and confirming that the services would be covered. The client also called Carelon and was told that the services would be covered. Carelon then denied coverage saying the provider was out of network despite being previously told that the services would be covered. The client is now responsible for almost $1400 in services and Carelon will not respond to appeals by the client or provider. A Carelon representative did tell a **** representative that it is charted in their records where the client and provider were told that the provider was in network in error by their staff. Carelon has made no attempts to resolve this issue and is no longer communicating with client or provider.Business Response
Date: 05/06/2025
Attached is Carelons response to ********.Initial Complaint
Date:04/23/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I am filing this complaint on behalf of our practice to formally report the gross negligence and ongoing misconduct by Anthem/BCBS/************************* of March 1, 2023, our practice, both individual and group, has been out-of-network with Anthem/BCBS. We submitted written notice on that date, and ****** confirmed the termination of our contract and removal from their provider panels effective immediately. Despite this, more than two years later, ****** has failed to update its provider databases and internal systems to reflect this change.This failure has caused substantial disruption to our business operations and significant confusion and distress for our clients, many of whom continue to be misled by ******* inaccurate directories. We have made multiple attempts to resolve this issue, yet the problem persists.Anthems persistent inaction is not only inexcusable, it is legally questionable. Their negligence exposes our practice to reputational harm, undermines client trust, and results in administrative and financial burdens that are entirely their responsibility.We are prepared to explore all available legal remedies if this matter is not addressed with urgency. Anthem/**** must be held accountable and compelled to immediately and comprehensively update their systems to reflect our non-participation status as of March 1, 2023.We respectfully request that the Better Business Bureau take this complaint seriously and investigate this ongoing misconduct.Customer Answer
Date: 05/05/2025
I have not heard from the business in response to my complaint. They have not returned my emails.Business Response
Date: 05/18/2025
See attached responseCustomer Answer
Date: 05/20/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
FAQ
Regards,*****
Initial Complaint
Date:04/22/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Why do you keep doing me like this ? I took my first step like week! I have pictures and videos ! Reference number: UM78280576 Patient first name: ****** Status: Deni** Treatment provid**: Functional activityx 12mins -Sit to stand in // bars with therapist blocking at R knee -prolong** dynamic standing activity with cross midline reach x2 rounds - pt/caregiver ** on use of custom AFO Gait training x23mins In //bars with therapist blocking at R knee and facilitating 2 x20ft Part task gait training with RLE stance/ LLE swing x10 and LLE stance/RLE swing x10 Therapeutic exercise x22mins Seat** heel slides with towel BLEs x30 Seat** hip add with ball x30 Prognosis for potential restorative function: Good - expect to meet goals set. Deferr**: see previous documentationBusiness Response
Date: 04/23/2025
Attached is Carelons response to 23234849.Customer Answer
Date: 04/24/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
FAQ
Regards,******
Initial Complaint
Date:04/04/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
We are a clinic that is contracted with Carelon Behavioral Health. We submitted a request to Carelon on 5/8/24. We were told that we would receive an email confirming receipt of request would be issued within ***** business days. In addition, we were told that our request would be addressed within ****** business days. Neither of these things occurred. Since then we have followed up on this request no less than 4 times. We have asked representatives to escalate the request and finally we asked a representative to file a grievance. All of which have gone no where. We are asking that the BBB please help us receive a response from Carelon acknowledging our request and providing a plan for addressing the request.Business Response
Date: 04/09/2025
Attached is Carelons response to ********.Initial Complaint
Date:03/27/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Credentialing And Enrollment IssueBusiness Response
Date: 03/31/2025
Attached is Carelons response to ********Initial Complaint
Date:03/12/2025
Type:Status:ResolvedMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
We have begun the credentialing process with Carelon Behaviorial health on August 26th, 2024. Since that time we received no communication regarding status of our application unless we contacted them via phone to which they would tell us that there is no timeline for turnaround for credentialing. We have many patients waiting to receive time sensitive and medically necessary *** therapy services from us but the delay is completely on Carelon's credentialing process as they provide no communication and have held our application for the past 7 months. In January, they told us to fax over additional information which we did and were told our application has been escalated but no change has occurred in status or communication. Every phone call we have with them they say the same thing: "There is no turnaround time or timeline for when this will be completed" while patients are waiting to receive services. The provider we are trying to credential has already been credentialed with ****** in the past and has been actively serving patients under another company. Carelon also had asked us to complete a second application for our entire group and that application was submitted February 17th, 2024 with no movement on that either. Our desire is that Carelon is held accountable for delaying the treatment of patients with *** services through their constant delays in the credentialing process and move the application forward as all necessary documentation has been provided.Business Response
Date: 03/16/2025
Attached is Carelons response to 23054584.Customer Answer
Date: 03/17/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
[You must provide details of why you are not satisfied with this resolution. If you do not enter a reason for your rejection, your complaint will be closed as Answered.]
The response from Carelon was specific to customer ********************** plans rather than provider credentialing. We are a provider looking to be credentialed and have beens stuck in this process since August 2024. We are requesting a swifter review of the application not benefits information.
Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
FAQ
Regards,Mohmeet
Business Response
Date: 03/31/2025
Attached is Carelons response to ********.Initial Complaint
Date:03/11/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
Carelon credentialing manager keeps ghosting me and will not return emails/phone calls. If I call customer service, I'm told to contact the guy who will not follow through on his statments/respond. Please see attachment.Business Response
Date: 03/16/2025
Attached is Carelons response to 23050390.Initial Complaint
Date:03/06/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I have been working to get outstanding claims processed through Carelon for maryland ******** for weeks with minimal response. Carelon took over this process on January 1st of 2025 after months of a transition from another processor.Since the turnover, all of my claims are sitting as "processing" for an excess of 30 days, some that are 75 days past date of service. When I call, the standard wait time is two or more hours on hold and the statement made at the limited "office hours" was that this is the current normal practice. The failure to process claims in a timely manner is causing undue stress and burden, and is outside of the agreed upon contract. I've tried to go through "proper channels" but I'm met with silence. I've never had any insurance company, private or public, ignore me and refuse to pay or process claims like this. The amount owed is in excess of $8000 and growing as I'm still providing necessary medical care to the insured, despite not being paid.Customer Answer
Date: 03/16/2025
I have not had contact from the business in response to my complaint on BBB. ***************** is still "looking into" my issues and they are in violation of the provider contract.Business Response
Date: 03/31/2025
Attached is Carelons no disclosure letter for ********.Initial Complaint
Date:02/18/2025
Type:Status:AnsweredMore info
Complaint statuses
- Resolved:
- The complainant verified the issue was resolved to their satisfaction.
- Unresolved:
- The business responded to the dispute but failed to make a good faith effort to resolve it.
- Answered:
- The business addressed the issues within the complaint, but the consumer either a) did not accept the response, OR b) did not notify BBB as to their satisfaction.
- Unanswered:
- The business failed to respond to the dispute.
- Unpursuable:
- BBB is unable to locate the business.
I contracted services as a Provider (LMHC) to Military One Source through Carelon Behaviroal Health from 2019-2024.I got a call from **** ****** on 10/11/2024 informing me that a client filed a complaint against me. I answered the question she had. A return call and email on 10/14/2024 stated that complaint was unsubstantiated. I got another call on 10/15/2024 telling me that the complaint was added to. I asked what that complaint was and she was not able to share what it was. On 10/21/2024 I received another phone call telling me that I was dropped from the program and had to call the clients that I had and tell them I could no longer see anyone through the program. I asked why and she said that is above her and could not tell me why. No one would give me anyone to talk to. On 10/21/2024 I got a letter of complaint from State of ***************************** (****) informing of this same client and her complaint. I sent to them my side of the story. I got a second letter from **** on 1/17/2025 stating that Upon review of all available evidence, a licensing law violation was not substantiated. I was cleared of all charges. I have those letter.Then I got a letter from Carelon 12/20/24 one month after the call dropped me from the contract telling what the charges were against me. These charges were different than the charges made to ****. I sent the same information to Carelon and they dropped me and refused to send me any information as to why I was dropped. I sent them a copy of everything I had. I asked for a copy of the case against me, and the reason why was a breech of contractual obligation. They gave me the codes but have not sent the contract that I requested from them. I sent another letter to **** ****** CPCS, but they have not replied to my request.I have a problem because in the letter they sent to me on 12/20/2024 it stated that I would be dropped on 1/20/2025 they breached contract by phone on 10/21/2024 by dropping me without warning.Business Response
Date: 02/24/2025
Attached is Carelons response to ********.Customer Answer
Date: 03/04/2025
Better Business Bureau:I have reviewed the response submitted by the business and have determined that the response does not satisfy or resolve my issues and/or concerns in reference to complaint # ********. Please add your rejection comments below; if you do not provide any details, your complaint will be closed as Answered.
I reject because they have responded to BBB, but not one phone call or email has come to me the provider. I am confused because they canceled my contract with Military One Source. But they still have me authorized to counsel under Carelon Behavioral Health (Quest) which pays a lot different. I still get phone calls to counsel under quest but not under Military One Source. I still don't know what the complaint is against me.
A different complaint was filed in the State of Hawaii, and a Release of Information (ROI) was signed in order for the state of Hawaii to investigate the complaint in order to give the provider a chance to the other side. They were able to clear me of all charges made by this same client. I have not been given the chance to prove myself innocent to the charges filed against me to Carelon, neither do I know the extent of the charges.
How is it I am not allowed to counsel Military members (MOS) as a retired member myself. Yet they allow me to counsel individuals at half the cost through Quest. If they feel I'm not safe to counsel Military, then how am I safe to counsel other members in our community? I am not getting any response from Carelon.
Businesses and Customers should be civil, courteous and polite in their responses to complaints. It is important to remain professional and productive when participating in the BBB complaint process.
FAQ
Regards,*******
Business Response
Date: 03/10/2025
Attached is Carelons response to 22958722.
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation. BBB charges a fee for BBB Accreditation. This fee supports BBB's efforts to fulfill its mission of advancing marketplace trust.