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There are Federal changes to Medicaid and new laws are changing the rules for NC Medicaid. Some people with Medicaid will have to follow new rules to keep their coverage. For more information, visit Medicaid is Changing | NC Medicaid. Access an NCDHHS toolkit of materials helpful in sharing this information.

Effective July 1, 2026, WakeMed is no longer in Alliance’s network for Tailored Plan services. Services provided by WakeMed after this date may be treated as out-of-network. Get full details here.

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Provider Updates

These updates support providers by highlighting new classes, trainings, resources, chats, procedures, and programs. You will also find advice and guidance for providers. Subscribe to updates or See Alliance News

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09/16/2026

Prior Authorization Request Submission Updates

PRTF Providers
Effective Thursday, October 1, PRTF providers will be required to complete a criteria review in Jiva, based on NC DHHS Clinical Coverage Policy 8D-1, when submitting all prior authorization requests, including both initial and continued stay. For detailed instructions on how to complete this process, please reference the Jiva Provider Portal User Guides on our website at UM Jiva Provider Portal Forms, Instructions and Videos – Alliance Health.

Peer Support (PSS) Providers
Please note that the changes to NCDHHS – Clinical Coverage Policy 8G  will soon be incorporated into the review within Jiva when submitting all prior authorization requests (both initial and continued stay) for this service. For detailed instructions on how to complete this process, please reference the Jiva Provider Portal User Guides on our website at UM Jiva Provider Portal Forms, Instructions and Videos – Alliance Health.

Research Based-Behavioral Health Treatment (RB-BHT) Providers
Please note that the state changes to NC DHHS – Clinical Coverage Policy 8F will soon be incorporated into the review within Jiva when submitting all prior authorization requests (both initial and continued stay) for this service. For detailed instructions on how to complete this process, please reference the Jiva Provider Portal User Guides on our website at UM Jiva Provider Portal Forms, Instructions and Videos – Alliance Health.

 

 

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