Carelon Claims Auditing & Support
Experiencing Issues with Carelon Maryland Medicaid Mental Health Claims? MCS Can Help.
Since the end of December 2024, Carelon Behavioral Health has taken over as the third-party administrator for Maryland Medicaid mental health claims — and the transition has caused widespread billing and payment disruptions for providers across the state.
At Medical Claims Solutions (MCS), we’ve been on the front lines working with Carelon and have developed effective strategies to audit claims, correct billing issues, and recover lost revenue. Our team has already helped practices recoup thousands of dollars from Carelon, including funds that were improperly retracted.
Our Carelon-Focused Services Include:
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Forensic audits of submitted claims and EOBs to identify denials, underpayments, and incorrect recoupments
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Investigation and dispute of unauthorized or inaccurate take-backs
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Direct follow-up and escalation with Carelon to resolve outstanding issues
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Consulting on front and back office processes to align with Carelon’s evolving requirements
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Staff training to reduce errors and improve first-pass claim acceptance
Why Choose MCS
Carelon’s system changes and administrative errors are causing providers to lose revenue through no fault of their own. At MCS, we bring in-depth knowledge of Carelon’s processes and a proven track record of results. We don’t just identify the problems — we get your money back.
Don’t let Carelon’s mistakes impact your bottom line. Let MCS audit your claims and help you get paid what you’ve earned.