What is Partners Health Management?

You will often hear people call Partners a Managed Care Organization or MCO. Some call us a Local Management Entity-Managed Care Organization or LME-MCO. Both are true. Think of us as part government agency and part insurance company. All the money we manage is for serving the behavioral health care needs of you and others in your community. The better we manage that money, the more services and programs we can provide.

The North Carolina Department of Health and Human Services contracts with Partners to manage behavioral health care services paid with federal, state, and local taxes. The sources of those funds include Medicaid (1915 (b)/(c) Medicaid Waiver), state and county funding, and grants.

Partners makes sure everyone who lives in Burke, Catawba, Cleveland, Gaston, Iredell, Lincoln, Rutherford, Surry, and Yadkin County and is covered by Medicaid or state health insurance or has no insurance at all receives the best possible services for mental health, substance use disorder, and intellectual and developmental disabilities.

You won’t actually see us for your services. We are here to ensure the behavioral health care provider you choose in our network meets strict standards for the services they offer. You can contact Partners if you have a concern or complaint about your provider. We also hear your appeals when you think you should get a service you are not currently eligible for. Most importantly, we guarantee all your rights are protected.

Partners does not offer incentives to Utilization Management employees or providers to deny (reduce, terminate or suspend), limit, or discontinue medically necessary services to any member. There are no financial rewards for Utilization Management decision makers that would discourage approval of services. Decisions made by Partners’ Utilization Management are based only on the appropriateness of care, the service requested, and existence of coverage.