Issued: April 3, 2023
Effective April 1, 2023, Partners began operating a NC Medicaid Direct Health Plan. NC Medicaid Direct is North Carolina’s health care program for Medicaid beneficiaries who are not enrolled in a Standard or Tailored plan.
NC Medicaid Direct includes care management by Community Care of North Carolina (CCNC) for physical health services. The six Local Management Entities/Managed Care Organizations (LME/MCOs) coordinate services for mental health, substance use disorders, intellectual/developmental disabilities or traumatic brain injuries.
What is happening? Partners is now operating a NC Medicaid Direct health plan.
When is this happening? April 1, 2023
How is this change impacting providers?
- Starting April 1, 2023, providers will operate under the NC Medicaid Direct contract. If your organization has not yet signed a NC Medicaid Direct agreement with Partners, you may do so by contacting Partners Contract team at firstname.lastname@example.org.
- Providers will continue to file claims for services through Alpha+. You may access Alpha+ by signing in to Partners secure provider portal, ProviderCONNECT, and clicking on Behavioral Health Claims. This will provide access to Alpha+.
- Authorization requests will continue to be submitted through ProAuth, also available through single sign on in ProviderCONNECT.
- NC Medicaid Direct includes three new service groups: 0-3; legal immigrants and NC Health Choice members. (NC Health Choice was discontinued and those members were rolled into the Medicaid coverage plans.)
Where can I find more information?
- Access Partners NC Medicaid Direct website at: partnersbhm.org/medicaid-direct/
- Access the state’s website at: gov/learn/benefits-and-services/nc-medicaid-direct-services
- Call Partners Provider Line at 1-877-398-4145