Carolina Complete Health Network equips providers to optimize care that is outcome-driven, evidence-based and cost effective. We have a commitment to uphold provider satisfaction starting by supplying you with tools and resources that are easy to find and supportive to your work. We will be adding to this section on an ongoing basis and welcome your input along the way. Please feel encouraged to reach out to your Provider Engagement Coordinator if you identify any unmet needs.
Join the CCHN Provider Engagement team on a New Provider Orientation. For instructions on how to attend, please visit our education and training site.
New Provider Orientations will cover:
If you are a Tier 3 AMH or Local Health Department, Carolina Complete Health’s Clinical Auditing Team would love to support you in the preparation for Go-Live! This team is able to set up mock-audits to walk you through the criteria for delegated care management. If you are interested, please reach out to CCH_Delegated_Oversight@carolinacompletehealth.com and they will be happy to help!
Registration is free and easy! Use the Log In button in the upper right hand corner of this webpage
Using the Secure Provider Portal (PDF), providers will be able to:
Claims may be submitted in 3 ways:
Carolina Complete Health's check write schedue is Tuesday and Friday beginning 7/20/21
Carolina Complete Health offers Payspan, a free solution that helps Providers transition into electronic payments and automatic reconciliation. Payspan will be available 30 days before implementation
The timely filing deadline for initial claims is 180 calendar days from the Date of Service, or in the case of a health care provider facility, within one hundred eighty days after the date of the member’s discharge from the facility.
Please visit the Claims and Billing section of our Provider Resources to view our billing manual.
Prior authorizations can be submitted in 3 ways:
Use the Prior-Auth Check Tool on the website to quickly determine if a service or procedure requires prior authorization. This tool will go live later this summer, before the launch of Medicaid Managed care.
Emergency services, family planning, post stabilization services, and table top x-rays do not require prior authorization.
Carolina Complete Health will use National Imaging Associates, Inc. (NIA) to provide the management and prior authorization of non-emergent, advanced, outpatient imaging services.
Referrals can be submitted via the Provider Portal, Fax or Phone. Any beneficiary seeking care from an out-of-network primary or specialty care provider will continue to require Prior Authorization, which is subject to Medical Necessity review.
Please use the Help STAT! link on the upper right hand corner of this website to quickly be connected with the Carolina Complete Health Network team. This information is routed to an internal email address, managed during business hours.
You may also contact Network Relations by calling 1-833-552-3876 or emailing Networkrelations@cch-network.com
Advanced Medical Homes (AMHs), Hospitals, and Health Systems, are encouraged to reach out directly to their designated Provider Engagement Coordinator.