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Attention Providers Affected by Hurricane Helene: If your organization is facing challenges due to Hurricane Helene and need assistance with medical, personal care, or specialized supplies, we are here to support you.  Please reach out to Carolina Complete Health as we are coordinating relief efforts for providers in the affected areas of Western North Carolina.  Click Here for More Information.

Tailored Plans

Carolina Complete Health is currently contracting providers for physical health for two Tailored Plans – Partners Health Management and Trillium Health Resources.

About Tailored Plans

  • Tailored Plans will cover the same physical health services as Standard Plans.
  • Additionally, Tailored Plans will cover specialized services for individuals with significant behavioral health conditions, intellectual/developmental disabilities (I/DDs), and traumatic brain injury (TBI), including Innovations and TBI waiver enrollees.
  • Carolina Complete Health was selected by two Tailored Plans – Partners Health Management (Partners) and Trillium Health Resources (Trillium). Together, we will serve over 65,000 Tailored Plan members.
  • As the first and only Provider-Led Entity, we look forward to working with you to improve access to health care in North Carolina.

Information for Tailored Plan Contracting

  • If you do not have a contract for the Tailored Plan network, you will be considered ‘out-of-network’ and could be subject to reduced reimbursement rates for physical health services.
  • Our team of network professionals is available to assist you in meeting critical dates for contracting. Please utilize our Contract Request Form.

Tailored Plan Trainings

Tailored Plan Provider Resources

Sharing from NC Department of Health and Human Services:

The Provider Playbook is a collection of information and tools specifically designed to assist providers transitioning to NC Medicaid Managed Care. The latest resources are added to the fact sheet page.

Frequently Asked Questions

Whether you receive your payments via paper check or ACH you will find them on the Payspan portal, via Payspanhealth.com. For providers not yet enrolled, visit https://www.payspanhealth.com/ and click register or contact Payspan: Call 1-877-331-7154, Option 1 – Monday thru Friday 8:00am to 8:00pm EST.  Also see attached guide. Using Payspan to Access Medical Home Payments (PDF)

Reach out to your CCHN Provider Engagement Administrator if you have any difficulty or questions, they are assigned by county.

If you do not have a contract for the Tailored Plan network, you will be considered ‘out-of-network’ and could be subject to reduced reimbursement rates for physical health services.

Our team of network professionals is available to assist you in meeting critical dates for contracting. Please utilize our Contract Request Form.

To be considered 'in-network’ and eligible for the full reimbursement rate for physical health services for Standard Plan members, providers should also be contracted with CCH for Standard Plan. Please see our Join the Network page for more information.

Page Last Updated: 08/13/2024