Partners Health Management - Provider Knowledge Base - Partners Provider Knowledge Base

NC Medicaid Direct Launched April 1, 2023

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Partners Website
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Provider Alert Update: IPRS / (b)(3) Funding - September 21, 2023

Provider Communication Bulletin #144 - September 21, 2023

Provider News(40)

Provider Alert: Partners Utilization Management Update: Prior Authorization Process
Provider Communication Bulletin #143
Provider Alert: Important Information – Medicaid Termination
Provider Alert: Partners Extends NC Medicaid Direct Flexibilities to September 30
Provider Communication Bulletin #142
Provider Alert: Alpha+ Processing Issues
Provider Alert: NC Medicaid Provider Reverification Process – Important Information

Provider Tools(8)

Identifying a Local Administrator
Transitioning to Alpha+
Provider Enrollment & Maintenance
Alpha+, ZixMail and Billing Set Up
Provider Monitoring
Provider Contracting
Provider Disputes

Access to Care and Utilization Management(8)

Universal Child Residential Placement Application
Partners State-funded Service Request & Waiting List Form
Access to Care, Member Eligibility and Enrollment
Utilization Management
Hospitals Working with Partners
Referrals to Specialty Treatment
Service Authorization Requests

Care Management(7)

Care Management Referral Form
Mental Health and Substance Use Disorders
Transitions to Community Living Initative
Intellectual and Developmental Disabilities
Registry of Unmet Needs
NC Innovations
Relative as Direct Support Employee

Finance, Claims and Billing(3)

Finance Documents and Forms
Claims and Rates Information
E-Verify

Clinical Tools(6)

Benefit Grids
Service Definitions
Clinical Practice Guidelines
Cultural Competency
EPSDT
Evidence-Based Practices

Quality Management and Corporate Compliance(7)

Quality Management and Global CQI
NC-TOPPS
Incident Reporting
Regulatory Compliance
Health Information Management
Program Integrity
Applicable Laws and Regulations for Regulatory Compliance

Additional Resources(8)

Electronic Visit Verification
Licensed Independent Practitioner Collaborative
IVC Designated Facilities
Consumer Relations, CFAC
File a Grievance/Complaint
System of Care and Family Partners
Housing Resources

Tailored Plan(4)

Resources & Training for Tailored Plan Tobacco Free Initiative
Tailored Plan Good Faith Contracting Efforts Policy
Partners’ Medicaid Provider Contract Templates
Partners Health Management Area Authority/BH/IDD Tailored Plan Contract

Quick Nav

Cardinal/Partners Service Code Crosswalk
State-funded Service Eligibility and Enrollment Information for providers serving members affected by County Realignment
Utilization Management Information for providers serving members affected by County Realignment
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AuntBertha
Pyx Health

Communication Bulletins

Provider Communication Bulletin #144
September 21, 2023 5:17 pm
Provider Communication Bulletin #143
August 17, 2023 2:10 pm
Provider Communication Bulletin #142
July 20, 2023 4:35 pm

Provider Alerts

Provider Alert: IPRS / (b)(3) Funding
Provider Alert: Partners Utilization Management Update: Prior Authorization Process
Update: Attention 1915(b)(3) Providers-Transition of 1915(b)(3) Codes

Accreditation

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