MemberConnect – Online Claims Submission Portal

If you are in treatment with a non-participating Carelon Behavioral Health provider and your provider has indicated that you will be responsible to file your claim, please go through the below steps to complete your claims submission process.

Submitting a claim to Carelon Behavioral Health requires two easy steps.

Step 1: Click here to download and fill out the form. The document contains detailed instructions for filling out the form.

Step 2: Submit the form to Carelon Behavioral Health. This can be done via mail or the online claim submission process below.

Online Claim Form






Please upload a file: