Complaints

This profile includes complaints for Carelon Behavioral Health., Inc.'s headquarters and its corporate-owned locations. To view all corporate locations, see Find Local Branches.

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• 

  Carelon Behavioral Health., Inc.

  200 State St Ste 302 Boston, MA 02109-2672

• 

  Carelon Behavioral Health., Inc.

  9925 Federal Dr Colorado Springs, CO 80921-3604

• 

  Carelon Behavioral Health., Inc.

  PO Box 1864 Hicksville, NY 11802-1864

The 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:04/22/2025

  Type:Service or Repair Issues
  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 documentation

  

  Business 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:Product Issues
  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:Service or Repair Issues
  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 Issue

  

  Business Response

  Date: 03/31/2025

  Attached is Carelons response to ********

• Initial Complaint

  Date:03/12/2025

  Type:Service or Repair Issues
  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:Order Issues
  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:Service or Repair Issues
  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:Product Issues
  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.
  

• Initial Complaint

  Date:02/13/2025

  Type:Product Issues
  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 **** based in ********, **. We have submitted a contracting request to Carelon on 11/01/2024 under Event ID# ******** and even after 4 months we have yet to receive a response from the Carelon on where we stand on the process. I have been credentialed with Carelon before and they already have my record. It was a simple application to add my new tax id and location to my record but whenever i call the representative do not even find the application themselves, I have to guide them on when i submitted the application, if i received a response from their department or not. All of this they should know themselves after taking all of my details. Then they give me a generic response stating " its still in process and there is no timeframe on the processing ". I have heard about the Carelon taking more than year to credential a new provider but i did not think i had to go through same process and timeline even if i am already credentialed with them under another location. I as a therapist in ** have many patients who have Anthem VA insurance and us rather than getting credentialed with Anthem directly, we have to go through Carelon which takes forever to get processed and our clients would eventually have to move to another therapist because they cannot afford to pay cash further hurting their mental wellbeing and our business. This is frustating for us both as a business and as a healthcare provider.

  

  Business Response

  Date: 02/20/2025

   Attached is Carelons response to BBB complaint 22938235.

  Customer Answer

  Date: 02/24/2025

  [A default letter is provided here which indicates your acceptance of the business's response.  If you wish, you may update it before sending it.]
  
  Better Business Bureau:
  
  I have reviewed the response submitted by the business and have determined that the response does satisfy my issues and/or concerns in reference to complaint #********. I understand that by choosing to accept the business response that my complaint will be closed as resolved. 
  
  Regards,
  
  ******* *********

  Customer Answer

  Date: 04/16/2025

  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. 

  We have started the credentialing process with Carelon Behavioral health on 10/30/2024. 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. In February, after a BBB complaint they reached out to us stating that something is missing from the application which we provided on the same day on 02/19/2025. After this we wanted to escalate the process which they didn't do stating that Carelon did not had the complete information until 2/19 so they will consider the application start date as 02/19. They never informed us of the missing information on our follow-up call and only informed after our BBB complaint and then they had the audacity to tell us that we have to wait ****** business days again to process the application. Our last communication with them was on 03/24 and after that they have vanished and are not responding to our emails. We requested them to backdate our contract to 04/01 on which we don't have response or confirmation. 

  

  Business Response

  Date: 04/16/2025

  Attached is Carelons response to ********.

• Initial Complaint

  Date:02/06/2025

  Type:Service or Repair Issues
  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 incredibly disappointed and disheartened by my experience with Carelon Health. While I was still inside a rehab center, working towards my recovery, my insurance claim was unjustly denied. Because of this, the rehab center kicked me out, despite my ongoing treatment. To make matters worse, Im now left with no place to go and am stranded with essential medical equipment that I need to maintain my health. This entire situation feels both heartless and unprofessional. Not only has it set back my recovery, but it has also left me in an incredibly vulnerable position. Its extremely frustrating and upsetting to be treated this way when all Ive been trying to do is get better. I strongly advise anyone to reconsider dealing with Carelon Health. They have shown a complete lack of compassion or support during one of the most difficult times of my life.

  

  Business Response

  Date: 02/09/2025

  Attached is Carelons response to ********.

  Customer Answer

  Date: 02/11/2025

  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:02/05/2025

  Type:Order Issues
  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 has been the most problematic insurance payor I have ever encountered in the credentialing and contracting process for Mieljade Behavioral Health, LLC to become an in-network *** group provider. I submitted my application in October 2023, and the entire experience has been nothing short of unacceptable. From January 2024 to November 2024, I was repeatedly told to allow more processing time while my application was supposedly being "escalated." This is utterly intolerable, especially since I was initially informed that credentialing would take 60 to 180 days. I later discovered that Carelon mishandled my application due to an incorrect group tax ID number and an inaccurate group provider address.After numerous grievances and complaints, my credentialing was finally approved after over a year. I received the participation agreement via email from ****** ******, the contract manager, on November 8, 2024, and again corrected the inaccurate information that I found in the contract regarding tax ID and service address. She corrected it and sent me a new contract which I signed and submitted immediately. However, despite my persistent follow-ups since November 18, I have finally received a response from ****** in January 2025 that they have corrected the updates of the contract to the credentialing team. We are in now in February 2025, I am still being told to allow for more processing time for my contract review. This is completely ridiculous. I am heading into my 16th month in the application process and was informed by Carelon to wait an additional 2-10 weeks for my information to uploaded in the system before they will release my welcome letter. How is Carelon still even existing? I am planning to take legal action at this point.

  

  Business Response

  Date: 02/06/2025

  Attached is Carelons response to ********.