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Partners Health Management – Provider Knowledge Base

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NOTICEProvider Alert: (b)(3) Deinstitutionalization Services Moving to NC Innovations Waiver - March 31, 2023

NOTICE Provider Communication Bulletin #138 - March 16, 2023

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(5)

  • Benefit Grids
  • Service Definitions
  • Clinical Practice Guidelines
  • 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 Concern or Grievance
  • 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

Provider News(20)

  • Provider Alert: (b)(3) Deinstitutionalization Services Moving to NC Innovations Waiver
  • Provider Alert: Updates to Partners’ Prior Authorization Process
  • Provider Alert: Claims Information Related to NC Medicaid Direct Launch on April 1
  • Provider Alert: Partners Implementing NC Medicaid Direct Flexibilities
  • Provider Alert: Clarification of Prior Authorization for Medicaid and State-funded Psychosocial Rehabilitation
  • Provider Alert: ProviderCONNECT and MemberCONNECT are Back Online
  • Provider Alert: ProviderCONNECT and MemberCONNECT Experiencing Outages

Provider Tools(9)

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

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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Communication Bulletins

  • Provider Communication Bulletin #138
    March 16, 2023 3:24 pm
  • Provider Communication Bulletin #137
    January 19, 2023 4:11 pm
  • Provider Communication Bulletin #136
    December 15, 2022 3:43 pm
View All

Provider Alerts

  • Provider Alert: (b)(3) Deinstitutionalization Services Moving to NC Innovations Waiver
  • Provider Alert: Updates to Partners’ Prior Authorization Process
  • Provider Alert: Claims Information Related to NC Medicaid Direct Launch on April 1
View All

Accreditation

NCR

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