Healthy Opportunities

The Healthy Opportunities Pilot (HOP) is a new federally-funded program to help improve the overall health of Medicaid beneficiaries. The goal is to help people who are struggling with housing stability, food security, transportation, and safety.

In North Carolina, the Department of Health and Human Services (DHHS) is implementing this program as a pilot in select counties.

HOP Provider Resources

• CCH Provider Guide: HOP (PDF)
  
• CCH Healthy Opportunities Pilot Eligibility and Referral Form
• NCCARE360 the first statewide coordinated care network to electronically connect those with identified needs to community resources and allow for a feedback loop on the outcome of that connection.
• NC DHHS Health Opportunities Fact Sheet (PDF)
• NC DHHS Healthy Opportunities Initiative website
• NC AHEC Webinar Series: Healthy Opportunities
  • View upcoming and archived webinars.

Human Service Organizations (HSO)

Human Service Organizations (HSOs) are community-based organizations or social service agencies that are contracted to deliver Pilot services. They play a critical role in delivering the 29 Pilot interventions to Pilot enrollees and other members of the community. HSO key Pilot responsibilities include:

• Delivering high-quality Pilot services in a culturally competent manner in accordance with Pilot standards;
• Building service capacity to meet community needs; and
• Developing capabilities to participate in the health care delivery system including tracking, reporting and invoicing for Pilot services delivered to Pilot enrollees.

HSO Resources

• CCH Portal Training Guide (PDF): how to use the Carolina Complete Health secure provider portal to check member eligiblity, view member health record, and view payment history.

Electronic Funds Transfer (EFT) for HSOs

• Payspan is an innovative web-based solution for Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs). By using Payspan, you can speed up the processing and payment of your claims. 
• Payspan: A Faster, Easier Way to Get Paid (PDF)
• To contact Payspan: Call 1-877-331-7154, Option 1 – Monday thru Friday 8:00 am to 8:00 pm est.
• NOTE: If an HSO is not already enrolled with Payspan, you will need to provide your 9-digit Tax ID Number (TIN) and PIN. Your PIN is listed as the Payee ID on your Carolina Complete Health Explanation of Payment (EOP). The EOP can be downloaded in the secure provider portal. For instructions, use the Portal Training Guide (PDF).