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NC Medicaid will delay Tailored Plan launch beyond October 2023. A new launch date has not been announced. Due to the budget delay, Medicaid Expansion will not launch on October 1, 2023. Final authority must be granted by the General Assembly.

Alliance Health
Provider Support: 855-759-9700
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Benefits and Services

Alliance Health authorizes an array of Medicaid and non-Medicaid (state-funded) services for individuals with mental illness, substance use disorders, and intellectual and developmental disabilities who reside in Cumberland, Durham, Johnston, Mecklenburg, Orange and Wake counties.

For details on benefit plan coverage, please visit our new Benefit Plan Service Details tool.

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Transition of Care: Requests to Move to NC Direct or LME-MCO

When providers have identified that a member requires specific services that are not covered by the Standard Plan, providers can submit a Request to Move to NCĀ MedicaidĀ Direct orĀ LME-MCOĀ form to theĀ enrollmentĀ broker. This form can beĀ submitted digitallyĀ or by calling theĀ enrollmentĀ broker at 833-870-5500 to request a downloadable form version that can be mailed or faxed.

This form can be used for two types of submissions, service associated requests and non-service associated requests. A service associated request is submitted by a provider with the beneficiaryā€™s consent requesting specific services only available through theĀ LME-MCO. It isĀ requiredĀ that a Service Authorization Request (SAR) (also known as a Treatment Authorization Request), and necessary supporting documentation is submitted with service associated requests.

For purposes of this transition, Alliance Health has developed aĀ Transition of Care Service Authorization Request formĀ that can be attached to the request to move form. Once the request to move form is received by Alliance Health, theĀ Utilization ManagementĀ Department will create a service request on behalf of the providers for purposes of a medical necessity review.

UM Resources – I/DD

This page provides information about the authorization of services for individuals with intellectual/developmental disabilities.

Out-of-Network Authorizations

Alliance makes every effort to first link consumers with Network Providers, but will consider enrolling an Out-of-Network Provider if a Network Provider is not available or accessible to the enrollee.

Non-Covered Services (EPSDT)

Learn more here about the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) benefit for Medicaid beneficiaries under the age of 21.
This page was last reviewed for accuracy on 08/03/2021

Alliance Provider Support is available to answer provider questions about authorization, billing, claims, enrollment, ACS, or other issues.

Call 855-759-9700 Monday-Saturday from 7:00am-6:00pm.