Health Plans
AmeriHealth Caritas North Carolina, Inc. – Prepaid Health Plan; Statewide
- Email: ProviderRecruitmentNC@amerihealthcaritas.com
- Phone: 844-399-0474
Healthy Blue of North Carolina – Prepaid Health Plan; Statewide
- Email: NC_Provider@healthybluenc.com
- Phone: 844-594-5072
UnitedHealthcare of North Carolina, Inc. – Prepaid Health Plan; Statewide
- Email: CarolinasPRTeam@uhc.com
- Phone: 800-638-3302
WellCare of North Carolina, Inc. – Prepaid Health Plan, Statewide
- Email: ProsProvNC@WellCare.com
- Phone: 855-599-3814
Carolina Complete Health, Inc. – Prepaid Health Plan, Regions 3, 4 and 5
- Email: networkrelations@cch-network.com
- Phone: 833-552-3876
- Behavioral Health I/DD Tailored Plan
- LME/MCO Directory
- Tailored Care Management including Request for Applications
- Email: ProviderNetwork@alliancehealthplan.org
- Phone: 919-651-8500
- Email: networkoperations@eastpointe.net
- Phone: 888-977-2160
- Email: contracts@Partnersbhm.org
- Phone: 877-864-1454, option 4, option 2
- Email: providercontracts@sandhillscenter.org
- Phone: 855-777-4652
- Email: networkservicessupport@trilliumnc.org
- Phone: 855-250-1539
- Email: provider.info@vayahealth.com
- Phone: 866-990-9712, select option 3
Eastern Band of Cherokee Indians (EBCI) Tribal Option is the Primary Care Case Management entity (PCCMe) created by the Cherokee Indian Hospital Authority (CIHA). It manages the primary care needs of federally recognized tribal members and others eligible for services through the Indian Health Service (IHS).
- Email: Provider.Services@cherokeehospital.org
- Phone: 800-260-9992
NC Medicaid Managed Care Health Plan Contracts
Standard Plans
The contract (i.e., Revised and Restated Request for Proposal (RFP)) reflects the original RFP issued Aug. 9, 2018, with all addenda and negotiation documents incorporated.
- Contract #30-190029 Prepaid Health Plan Services and Draft Rate Book
- Contract #30-190029 Prepaid Health Plan Services Amendment 1
- Contract #30-190029 Prepaid Health Plan Services Amendment 2
- Contract #30-190029 Prepaid Health Plan Services Amendment 2/3
- Contract #30-190029 Prepaid Health Plan Services Amendment 3/4
- Contract #30-190029 Prepaid Health Plan Services Amendment 4/5
- Contract #30-190029 Prepaid Health Plan Services Amendment 5/6
- Contract #30-190029 Prepaid Health Plan Services Amendment 6/7
- Amerihealth Attachment M.10. Approved In Lieu of Services
- Carolina Complete Health Attachment M.10. Approved In Lieu of Services
- Healthy Blue Attachment M.10. Approved In Lieu of Services
- UnitedHealthcare Attachment M.10. Approved In Lieu of Services
- WellCare NC Attachment M.10. Approved In Lieu of Services
- Contract #30-190029 Prepaid Health Plan Services Amendment 7/8
- Contract #30-190029 Prepaid Health Plan Services Amendment 8/9
- Contract #30-190029 Prepaid Health Plan Services Amendment 9/10
- Contract #30-190029 Prepaid Health Plan Services Amendment 10/11
- Contract #30-190029 Prepaid Health Plan Services Amendment 11/12
- Contract #30-190029 Prepaid Health Plan Services Amendment 12/13
- Contract #30-190029 Prepaid Health Plan Services Amendment 13/14
- Contract #30-190029 Prepaid Health Plan Services Amendment 14/15
- Contract #30-190029 Prepaid Health Plan Services Amendment 15/16
Behavioral Health I/DD Tailored Plans
The Contract (I.e., First Revised and Restated Request for Application (RFA)) reflects the original RFA issued Nov. 13. 2020, with all addenda and negotiations documents included.
- Contract #30-2020-052 Behavioral Health and I/DD Tailored Plan Amendment 1
- Contract #30-2020-052-DHB TP Amendment 2 (Model 06072023)
- Alliance Health M. 13 Approved In Lieu of Services
- Eastpointe Human Services M. 13 Approved In Lieu of Services
- Vaya Health M. 13 Approved In Lieu of Services
- Sandhills M. 13 Approved In Lieu of Services
- Trillium Health Resources M. 13 Approved In Lieu of Services
- Partners Health Management M. 13 Approved In Lieu of Services
- Contract #30-2020-052-DHB TP Amendment 3 - HOP Requirements Only (Model)
NC Medicaid Direct
#30-2022-007-DHB_MDPIHP_Contract_Model_20220804
- Contract #30-2022-007-DHB MD PIHP Amendment 1 (Model March 2023)
- (Trillium Health Resources) Attachment L. Policies, 7. Approved In Lieu of Services
- (Partners Health Management) Attachment L. Policies, 7. Approved In Lieu of Services
- (Sandhills Center) Attachment L. Policies, 7. Approved In Lieu of Services
- (Eastpointe Human Services) Attachment L. Policies, 7. Approved In Lieu of Services
- (Alliance Health) Attachment L. Policies, 7. Approved In Lieu of Services
- (Vaya Health) Attachment L. Policies, 7. Approved In Lieu of Services
- Contract #30-2022-007-DHB MD PIHP Amendment Number 2 (Model)
Primary Care Case Management Entity
- 30-2021-061-DHB CCNC PCCMe Contract
- 30-2021-061-DHB CCNC PCCMe_Amendment
- 30-2021-061-DHB CCNC PCCMe Contract Amendment 2
- 30-2021-061-DHB CCNC PCCMe Contract Amendment 3
EBCI Tribal Option
EBCI: To request a copy of the EBCI PCCMe contract, email medicaid.transformation@dhhs.nc.gov. Please be sure to note the request is for the EBCI PCCMe contract.
