August 11, 2025

Dear Provider,  

Carolina Complete Health is partnering with Healthmap Solutions (Healthmap) to provide care coordination services within our kidney health management (KHM) program. As a leading national kidney health management company, the partnership with Healthmap will provide more comprehensive care for members with chronic kidney disease (CKD) stages 3, 4, 5, and end stage renal disease (ESRD).  

If you have a patient with kidney disease, or chronic conditions that may lead to kidney disease, Healthmap may contact you to facilitate care. Healthmap provides collaborative recommendations through workflow-friendly clinical decision support.  Healthmap’s KHM program integrates into your existing practice workflow to complement your patient’s current plan of care. Healthmap can supply you with actionable information, based on industry proven best practices, and powered by data analytics, to more effectively anticipate and deliver the right clinical care.  

We appreciate your ongoing care for our members. Be on the lookout for outreach from Carolina Complete Health and Healthmap for the introduction to our kidney health management (KHM) program. If you have any questions or concerns, please contact your Provider Engagement Administrator.

Sincerely, Carolina Complete Health 

As part of ongoing system maintenance, Carolina Complete Health's authorization system will be upgraded, requiring a scheduled system outage Friday, Oct. 10, 2025, at 11:00 p.m. EST (10 p.m. CT) through Monday, Oct. 13, 2025, at 8:00 a.m. EST (7 a.m. CT.)

During this scheduled outage, we will be unable to receive authorization requests except as noted below. Please resume submission of your authorization requests on Monday, Oct. 13, 2025.

How to Plan for the Outage:

• Plan accordingly and submit any urgent or time-sensitive authorization requests prior to the scheduled downtime.
• For urgent authorization requests during the outage, call 1-833-837-0188. Of note, this number will only be active during this downtime.
• Beginning on Monday, Oct. 13, 2025 at 8:00 a.m. EST (7 a.m. CT), providers may submit authorization requests as usual. 

If you have questions, please contact your Provider Engagement representative.

We are please to share that effective July 28, 2025, the Carolina Complete Health Standard Plan check run schedule will be updated to Monday, Wednesday and Friday, with payment issued to providers the following business day. Previous check run schedule was weekly on Tuesday and Friday.

Providers can check claim status, view payment history, and access Explanations of Payment (EOPs) using the Carolina Complete Health Secure Provider Portal. 

Please reach out to Provider Services if you have any questions at 1-833-552-3876.