Carelon
Carelon is a Health services company, subsidiary of Elevance Health (formerly Anthem).
What is utilization management?
“Utilization management is an evidence-based approach that helps health plans evaluate the clinical appropriateness of care and services. It supports informed care decisions while helping improve quality, manage costs, and promote better experiences for members and providers.”
View in the company profileWhat is utilization review?
“Utilization review is the process of evaluating healthcare services to determine whether they are clinically appropriate and consistent with evidence-based guidelines. It is an important part of utilization management and helps support appropriate, high-quality care.”
View in the company profileWhat is medical benefits management?
“Medical benefits management helps health plans manage services covered under the medical benefit. Carelon combines clinical expertise, technology, and utilization management to support evidence-based care, streamline provider workflows, improve the member experience, and help manage healthcare costs.”
View in the company profileWhat does medical benefits management support?
“Medical benefits management can support a range of diagnostic, specialty, complex, and post-acute care needs. Carelon solutions span areas including radiology, cardiovascular care, sleep, surgical procedures, musculoskeletal care, rehabilitation, oncology, genetic testing, and post-acute care.”
View in the company profile