Trillium Tailored Plan Provider Resources
Contact Us and Resources
- Trillium Provider Support Service Line: 1-855-250-1539
- Trillium Member & Recipient Services: 1-877-685-2415
- Trillium Behavioral Health Crisis: 1-888-302-0738
- Carolina Complete Health Network Provider Engagement Team
- Tailored Plan Information for Trillium Providers
Training and Resources
Provider Portal
Trillium Physical Health Portal Setup:
- To access the Trillium Physical Health Portal, contracted providers must identify an individual who will serve as the Portal Account Manager.
- The Account Manager should follow the prompts using the portal link to create an account, validate their email, and register the Tax ID Number (TIN)
- After registering, email your assigned Provider Engagement Administrator email ProviderEngagement@cch-network.com to request verification of your portal registration request and assignment as Portal Account Manager.
Trillium Physical Health Portal Link
Provider Forms
- For Trillium Tailored Plan members, please complete the DHB 3051 Form: when making a referral for a PCS assessment or reassessment. Form can be emailed to LTSS@trilliumnc.org using the “Submit” button on the form, or by saving to your desktop and emailing as an attachment.
Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA)
- Payspan is an innovative web-based solution for Electronic Funds Transfers (EFTs) and Electronic Remittance Advices (ERAs), also known as 835s.
- 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: In November of 2022, Zelis, a company modernizing the business of healthcare, completed the acquisition of Payspan. Read on for more details. Providers should continue using the Payspan payment portal.
Claim Submission
Physical health claims for Trillium Tailored Plan members are processed by Carolina Complete Health.
View Trillium's Claim Submission Protocol under Claims/Finance Information & Forms
You can submit physical health claims in any of the following ways:
| Method | Claim Submission Instructions |
|---|---|
| Portal | Trillium Physical Health Portal |
| Trillium Health Resources PO Box 8003 Farmington, MO 63640-8003 | |
| Clearinghouse/EDI | Provider’s Clearinghouse connection to Availity for Claims processing. |
| Payer ID | 68069 |
Trillium Network Communication Bulletin #369
Trillium's hardship process supports our providers when they have reached a financial hardship status for various reasons. Trillium's process supports providers from start to finish through the process. A provider may claim a hardship payment via email communication to the Financial Hardship team at TrilliumFinance@TrilliumNC.org due to delays in claims processing or other operational concern.
Trillium Prior Auth Flexibilities
Trillium will initiate a no prior authorization required period for physical and behavioral health services to ensure Providers with contracts will be able to file claims for dates of service from July 1, 2024 through January 31, 2025 without authorization.
Pre-Auth Tool
To check on a specific physical health service or procedure for Trillium Tailored Plan members, use the Pre-Auth Tool. Providers should also review the Clinical Coverage Policy for specific details on services and procedures.
Trillium Physical Health Pre-Auth Tool
Authorization Submission
Physical health authorizations are reviewed by Carolina Complete Health. Please use one of the following methods to submit a physical health PA.
| Method | Physical Health PA Submission Instructions |
|---|---|
| Portal | Trillium Physical Health Portal |
| Fax | Use the Trillium PA Fax Form (PDF) and submit to one of the following:
|
| Phone | Call Trillium Provider Support Service Line at 855-250-1539 to be connected to the physical health utilization management team. |
Non-emergent, Advanced, Outpatient Imaging Services
- In an effort to continue promotion of quality improvement for services provided to Trillium members, effective July 1, 2024, Trillium will use Evolent, formerly known as 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:
- CT/CTA
- CCTA
- MRI/MRA
- PET Scan
- MUGA Scan
- Myocardial Perfusion Imaging (MPI)
- Stress Echocardiography
- Echocardiography
- Please visit Evolent's website for Trillium Health Resources 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