1­-877­-864­-1454

Frequently Asked Questions for Providers

County Realignment

Cabarrus, Union and Stanly County Boards of County Commissioners have passed resolutions to disengage from Cardinal Innovations Healthcare and align with Partners. Each of the three counties have submitted their requests to realign to the Secretary of North Carolina Department of Health and Human Services.

Forsyth County’s Board of County Commissioners voted on March 4 to begin the process for realignment. To review the plan, visit https://forsyth.cc/disengagementplan.aspx.

Counties that request to realign with a different local management entity/managed care organization (LME/MCO) must submit their request and disengagement plan for approval of the Secretary of the North Carolina Department of Health and Human Services (NC DHHS). For information on the county disengagement process, go to:
https://ncdhhs.gov/divisions/mhddsas/lme-mcos

 

Providers that serve citizens in realigning counties who have Medicaid or have no health insurance, and who receive Mental Health, Substance Use Disorder or Intellectual and Developmental Disabilities services may be impacted if the realignment is approved. 

Yes. Partners will work with providers currently serving realigning counties to include them in Partners’ Provider Network. Partners will honor member service authorizations, annual plans and other documentation and decisions essential to ensure a smooth transition. 

Partners has a philosophy of a broad provider network, ensuring choice and access for members in the county. Though LME/MCOs are permitted to have a “closed network”, Partners has never limited provider enrollment in that way. We welcome all providers who are in good standing with state minimum qualifications and will not limit entry to the network based on size of the providers or the continuum of services offered. 

All rates paid to current providers for services for services to residents in realigning counties will remain the same. Providers will continue to be paid their current rates after the transition to Partners. If Partners rate is a higher rate, Partners will work with DHHS to create the opportunity to provide the higher rate to current providers. At a minimum, all provider rates will remain whole compared to where they are now. 

Yes, please complete the online Request for Consideration Form. We will then collect your information and work with you to complete that process now, understanding that Partners would not be responsible for member coverage in those impacted counties until the County Realignment is approved the Secretary of North Carolina Department of Health and Human Services. 

Yes, please complete the online Request for Consideration Form. We will then collect your information and work with you to complete that process now, understanding that Partners would not be responsible for member coverage in those impacted counties until the County Realignment is approved the Secretary of North Carolina Department of Health and Human Services. 

Yes. Please use the Provider Change Form to add all sites/services/clinicians serving members from these counties. We will then collect your information and work with you to complete that process now, understanding that Partners would not be responsible for member coverage in those impacted counties until the County Realignment is approved by DHHS. 

Yes. Once the Request for Consideration has been processed you should receive a link to the credentialing application to start the process of being credentialed with us. If you have questions about the status of your request to join please contact us at PNAS@partnersbhm.org. If you have already received the link to the credentialing application please follow the instructions for completing the process or contact us at credentialingteam@partnersbhm.org for a status update. 

This process requires that you receive a letter of support from the entity that is currently responsible for the county. You would need to receive the Letter of Support from Cardinal until the County Realignment has been approved by DHHS. Partners would provide the Letter of Support after the official date of realignment. 

Partners is committed to continuity for members as part of county realignment. Services that are not currently in Partners benefit grid, such as specialty or In Lieu Of services, will be addressed once we have approval for the county realignment. 

X