Emergency services, family planning, post stabilization services, and table top x-rays do not require prior authorization.
Prior authorizations can be submitted in 3 ways:
For Prior Authorization Form, please visit our Manuals, Forms, and Guides page.
For Behavioral Health UM Prior Authorization Guidelines, please visit our Manuals, Forms, and Guides page.
For Pharmacy Prior Authorization forms, please visit our Pharmacy page.
|Fax Number Reference Guide|
|833-238-7690||Carolina Complete Health Medicaid Face Sheets|
|833-238-7691||Carolina Complete Health Medicaid Assessments|
|833-238-7692||Carolina Complete Health Medicaid Concurrent Review|
|833-238-7693||Carolina Complete Health Medicaid Medical Records|
|833-238-7694||Carolina Complete Health Medicaid Prior Authorization|
|844-975-1325||Carolina Complete Health Medicaid Census Reports|
|833-596-2768||Carolina Complete Health Inpatient Behavioral Health PA|
|833-596-2769||Carolina Complete Health Outpatient Behavioral Health PA|
In an effort to continue promotion of quality improvement for services provided to Carolina Complete Health members, effective July 1, 2021, Carolina Complete Health will use National Imaging Associates, Inc. (NIA) to provide the management and prior authorization of non-emergent, advanced, outpatient imaging services.
Services managed and authorized by NIA include outpatient:
Please visit NIA's website for Carolina Complete Health to download policies and procedures specific to both ordering providers and imaging facilities. These include quick reference guides and FAQs. You can also view information designed to assist you in using the RadMD Website to obtain and check authorizations