Do you know about Carolina Complete Health's Value-Added Services? Check them out on the new VAS Provider Guide (PDF)
About the Merger Between Carolina Complete Health and
WellCare of North Carolina
As a valued provider in the Carolina Complete Health (CCH) and WellCare of North Carolina (WellCare) networks, your partnership is essential to our shared mission of transforming the health of the communities we serve, one person at a time.
We are 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 North Carolina Department of Health and Human Services (NC DHHS). The new entity will be known as Carolina Complete Health and will maintain its Provider Led Entity governance structure. This transition reinforces our commitment to simplifying and strengthening our partnership with you.
To support your success during this transition, we will update this page on a regular basis with important resources, tools, and guidance tailored to providers.
Thank you for your continued dedication to our members and to the future of care in North Carolina.
A Commitment to Provider-Led Managed Care
The statewide PLE will continue to be governed by North Carolina physicians. The role and charter of the Medical Affairs Committee will remain intact. We are 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.
Merger Frequently Asked Questions
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.
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 1-877-331-7154, option 1.
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).
Providers holding contracts with either WellCare or CCH will be considered in-network with the new merged entity.