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Statewide Provider-Led Entity (PLE) Implementation
Preparing for Go-Live: Carolina Complete Health and WellCare of North Carolina unite as the first and only statewide Provider-Led Entity (PLE).
As a valued provider in the Carolina Complete Health (CCH) and WellCare of North Carolina networks, your partnership is essential to our shared mission of delivering high-quality care to communities across North Carolina.
We’re excited to share that CCH and WellCare will officially combine into a single, statewide health plan. The implementation date is scheduled for April 1, 2026, unless otherwise communicated by NC DHHS. The new entity will be known as Carolina Complete Health and will preserve the governance structure of a Provider Led Entity, continuing our commitment to simplifying and strengthening our collaboration with providers like you. Your partnership is essential to our shared mission of delivering high-quality care to communities across North Carolina.
To support your success during this transition, we’ll be updating this page regularly with important resources, tools, and guidance tailored to providers. Please check back often for the latest updates and materials to help you navigate the go-live and beyond.
Thank you for your continued dedication to our members and to the future of care in North Carolina.
The statewide PLE will continue to be led by North Carolina physicians. The Medical Affairs Committee’s role and charter will remain intact. We remain committed to continuing to listen to our providers and incorporating your thoughts into our policies that will ultimately serve the patients you treat every day. The combined health plan will also remain partially owned by the NC Medical Society, the NC Community Health Center Association, and Federally Qualified Health Centers.
Frequently Asked Questions
Category
Operations (Claims and Provider Relations)
Carolina Complete Health offers a free solution for payment by Electronic Funds Transfer (EFT) and Electronic Remittance Advice (835)/Explanation of Payment (ERA/EOP) through PaySpan®. If you are not already registered, create a new account by registering at payspanhealth.com or calling 877-331-7154, option 1.
Provider Resources
For CCH providers, the public website will remain https://network.carolinacompletehealth.com/. WellCare providers should begin using this webpage upon go-live (anticipated to be 4/1/2026) for updated materials (i.e. provider and billing manuals, contacts, and provider tools).
Contracting
Providers holding contracts with either WellCare or CCH will be considered in-network with the new merged entity.
Claims
Provider Data Management
We are closely monitoring our market share, and while we are close to the cap in a couple of regions, we do not believe the cap will have a material impact on our membership. We are also actively working with the State to ensure compliance. The State will make auto-assignment adjustments to address a situation where we are over the cap. This will take place beginning 4/1/2026.
The necessary adjustments to stay under the cap would be handled through the State’s auto-assignment process, and we do not anticipate manual reassignments. For regions where the combined member enrollment reaches the 40% ceiling, the Department will turn-off auto-assignment to Carolina Complete Health until the member enrollment falls below 40%. This will take place beginning 4/1/2026.
Contact Us
- If you are a provider, please call 1-833-552-3876 for Provider Services.
- For network inquiries, contact NetworkRelations@CCH-Network.com
- To contact Provider Engagement, see our Provider Engagement Contact List.
- For phone and fax numbers related to submission of prior authorzations, visit the Prior Authorization page.
- For mailing addresses for claim correspondance, grievances, appeals, and more, see the Provider Manual and Billing Manuals.
Additional Resources
Page Last Updated: 01/06/2026