Sutter Health Plus (Sutter Health Plan) Carelon Credentialing for Therapists

What changed, and the name

• The name. Sutter Health Plus announced it would do business as Sutter Health Plan starting January 1, 2025 (Sutter Health Plan announcement). Clients and older documents still say Sutter Health Plus; it is the same plan.
• The behavioral health partner. Sutter Health Plan says Carelon Behavioral Health of California, Inc. replaced U.S. Behavioral Health Plan, California (USBHPC) as its behavioral health plan partner effective January 1, 2026 (Optum’s provider site describes USBHPC as the legal name behind its California Optum branding, Provider Express: CA logo change), that Carelon now manages all mental health and substance use disorder services covered under Sutter Health Plan benefits, and that benefits did not change (Sutter Health Plan: Carelon FAQ; Sutter Health Plan news).
• Transition period. Sutter Health Plan said members could keep seeing their current behavioral health provider until May 1, 2026, and could ask for continuity of care after that, with requests due by March 2, 2026. Those dates have passed, so a provider who is not in the Carelon network is now out of network for Sutter Health Plan members unless the member has an approved continuity of care arrangement.

How to get in network with Carelon for Sutter Health Plan

1. Check whether you are already in the Carelon network. If you are contracted with Carelon for other plans, ask Carelon whether your contract includes Sutter Health Plan. Sutter Health Plan points members to Carelon’s search at carelonbh.com/sutterhealthplan.
2. Get your CAQH ProView profile complete and attested, with Carelon authorized. See CAQH ProView for therapists.
3. Register with Availity if you have not already (Availity).
4. Submit a network enrollment request in the Carelon Behavioral Health payer space. Sutter Health Plan says Carelon partners with Availity to process network enrollments and that out-of-network providers can use the Availity portal to ask to join (Sutter Health Plan: Carelon FAQ). Carelon says all new enrollment requests go through Availity (Carelon: join our network).
5. Name Sutter Health Plan in your request and note your Sutter-area locations, so Carelon knows which network you are asking for.
6. Allow up to 60 business days. That is the timeline Sutter Health Plan publishes. Follow up through Availity, and by email at provider.inquiry@carelon.com, which Sutter Health Plan lists for provider questions.
7. Sign the contract and note your effective date.
8. Ask Carelon which portal to use for Sutter Health Plan members (ProviderConnect or eServices). Carelon’s California resources page has sections for Kaiser Northern California and several Medi-Cal plans but, as of October 19, 2026, no Sutter Health Plan section, so I could not confirm the portal in an official source (Carelon: California resources). Both are reached through Availity under Carelon’s payer ID BHOVO (Carelon: provider portals).
9. Set up payments. Carelon is moving electronic payments to Zelis (Carelon: Zelis transition).

Seeing Sutter Health Plan members after you are in

• Verify eligibility and benefits for every new client and at every plan year. Ask Carelon whether outpatient therapy needs an authorization for that member and what the member’s cost share is.
• Bill Carelon, not Sutter. Confirm the payer ID and claims address in your Carelon welcome materials. Carelon’s standard payer ID is BHOVO, and it says to check state-specific materials in case another ID applies.
• Timely filing follows your Carelon agreement; Carelon’s national handbook default is 90 days from the date of service if your agreement is silent (Carelon provider handbook).
• Document start and stop times for timed psychotherapy codes, as Carelon’s handbook requires.

Bill for what you legitimately provide and document, and follow the payer’s authorization and documentation rules. For how Carelon authorizations and authorization numbers work in general, see my Kaiser/Carelon billing guide; confirm what applies to Sutter Health Plan with Carelon.

Contacts Sutter Health Plan lists

Associates and groups

Associate billing must be confirmed in writing with each payer, including Carelon for Sutter Health Plan. Carelon’s handbook says providers should not bill in their own name for services provided by an intern or another clinician, and I couldn’t find a public Sutter or Carelon rule on associates for this plan. See Can associates bill insurance in California?. If you are a group, make sure Carelon has every clinician and location you plan to use.

Common mistakes

• Assuming your Optum contract still covers Sutter members. Since January 1, 2026, it does not for Sutter Health Plan behavioral health.
• Sending claims to Sutter Health Plan instead of Carelon.
• Searching for “Sutter Health Plus” and missing current materials published under Sutter Health Plan.
• Not following up on an Availity enrollment request for weeks.