Interested in becoming a Network Provider with Alliance Health? Our Credentialing and enrollment page provides everything you need to know.
At this time we are not accepting applications for network membership at large. However, from time to time, targeted service needs may be identified and these will be posted on this website and in the Alliance provider news feed. View any service needs currently in effect.
- All fully-licensed and associate-licensed outpatient therapists need to be credentialed by Alliance. Please ensure enrollment applications are submitted for all of these clinicians.
- Alliance’s Credentialing Department requires that all applications and subsequent required documentation be submitted via email attachment only. Anything received via fax, mail, delivery service or by dropping off at office will not be accepted. All credentialing information can be emailed to [email protected].
- Currently contracted agencies and group practices that wish to add additional clinicians will be required to complete a Request to Add Licensed Clinician.
- This form will be reviewed and a checklist of needed documents, along with the application, will be emailed to the requesting provider. The application and required documents will need to be submitted in its entirety or the application will not be accepted and will be returned to the provider. Applications that are received outside of this process will be returned to the provider.
Guidance regarding NCTracks Enrollment and Alliance Credentialing
Alliance strongly recommends that providers and sites that are currently going thru the Alliance credentialing process and any future enrollment/credentialing requests and are not currently enrolled in NCTracks to enroll in NCTracks effective immediately. Alliance will not be able to enroll providers in Alpha until the provider is successfully enrolled in NCTracks.
Alliance will continue to credential providers. Providers may receive two notification letters from Alliance. A provider will receive a credentialing letter once a credentialing decision has been made. However, if a provider is not enrolled in NCTracks the provider will not be enrolled in Alliance and entered into Alpha until the provider is successfully and correctly enrolled in NCTracks. Providers are responsible for notifying Alliance at [email protected] once they are enrolled in NCTracks. The provider will receive a separate enrollment notification from Alliance once Alliance is able to confirm verification that the provider is enrolled correctly in NCTracks. If a provider is enrolled in NCTracks at the time the credentialing approval is completed they will receive only one letter, a credentialing/enrollment approval letter.
Providers and organizations participating in the credentialing and re-credentialing process have certain rights. Provider/organizations rights are as follows:
- Providers and organizations applying have the right to review information obtained from outside sources used to support an application. This does not include references, recommendations, or peer-protected information.
- Providers and organizations applying have the right to correct erroneous information from other sources. Erroneous information must be corrected in writing via email to the credentialing specialist within 7 calendar days from notification.
- Providers and organizations applying have the right to be informed of their application status upon request. Providers/organizations can request status updates from their assigned credentialing specialist via phone or email. Credentialing specialists may provide status updates on missing information from an application packet, results of background checks, and an estimated time frame for credentialing to be sent to the Credentialing Committee through encrypted email to providers/organizations.
- Email [email protected] to receive updates to a previously submitted application.
Members of the Alliance Provider Network are required to purchase and maintain certain types and amounts of insurance from a company licensed and authorized to do business in the State of North Carolina by the North Carolina Department of Insurance. Get full details on the insurance requirements and see below for special additional information for specific groups of providers.
Professional Liability Insurance Requirements for Agencies and Groups that Provider Outpatient Therapy
- Agencies and groups that provide outpatient therapy and/or psychiatric services must list each practitioner on the agency/group professional liability insurance certificate who are credentialed with Alliance. Alliance requires a copy of the agency/group professional liability insurance certificate and/or attachments on the insurance company’s letterhead that lists the practitioner and coverage limits or the attestation letter and copy of the agency/group insurance certificate when an enrollment application is submitted for each practitioner. Access a sample attestation letter.
- Agencies may also submit a certificate for their agency that lists all of their practitioners to help reduce numerous requests to insurance companies. When adding new practitioners, agencies would be required to submit the updated professional liability certificate with the new practitioner added. This includes any practitioners (both contractors and employees) that are billing under the agency
- If the agency/group covers the practitioner (contractor) under a vicarious liability policy, the practitioner is required to have their own individual policy that meets the professional liability criteria ($1 million to $3 million).
Important Information for LIPs in Solo Practice Concerning Comprehensive General Liability Insurance
To be in accordance with Alliance’s contract with the state all contracted LIP solo entities will be required to purchase and maintain comprehensive general liability insurance which includes bodily injury and property damage liability insurance protecting the provider and any employee performing work under thecontract from claims of bodily injury or property damage arising from operations under the contract for an amount of notless than $1,000,000.00 per occurrence/$3,000,000.00 annual aggregate. Contracts will not be renewed for providers that do not submit this required insurance information. Any new LIP solo providers initially credentialed and/or contracted with an effective date after October 25, 2017, will be required to have this coverage to meet credentialing and contracting requirements. Questions can be submitted by email.
Notifying Alliance of Changes in Business Operations
All providers are required to notify Alliance at ProviderNetw[email protected] in advance regarding potential site address changes, mergers/acquisitions, name or tax ID changes, or any other potentially significant changes that may be under consideration. Alliance staff will work with providers to identify any issues that may arise due to potential changes and how to best navigate within the MCO model around these changes. Please complete a Notice of Change Form indicating any changes and submit to [email protected]
Credentialing and Enrollment Q&A
Alliance conducts re-credentialing of all our credentialed providers at a minimum every three years. It is Alliance’s goal to notify providers of their re-credentialing due date a minimum of four months before the due date. It is the provider’s responsibility to ensure that Alliance has the most current, updated contact information so that information may be received in a timely manner.
Network providers will have 30 days from the date they receive their re-credentialing application packet to submit their completed application packet. Technical assistance is available to assist with any ongoing questions during the process.
- It is important that once a network provider has been notified to be re-credentialed that all identified timeframes and expectations for the re-credentialing process are met in order to stay enrolled in the Alliance network.
- Re-credentialing is ONLY for sites and services that you are already enrolled in the Alliance network to provide. This is not an opportunity to add sites and services.
- All submissions need to be electronic (e-mail). We will not accept fax, delivery (mail, FedEx, etc.) or hand-delivered applications.
- Re-credentialing packets need to be submitted in their entirety. Incomplete applications will not be accepted and will be returned to the provider.
- Below is a list of items that may be requested during the re-credentialing:
- NPI number should match at least one site location under the agency (typically the main site location). If a provider wishes to use unique NPI numbers for each practicing site location they may do so by indicating the specific/unique NPI number on the site enrollment form.
- NCTracks – ensure each NPI number (agency, site and LP) is registered in NCTracks and that benefit plans have been chosen.
- Organizational chart (if applicable) needs to list positions as well as names associated with the positions.
- Identify owners, managing employees, board of directors, CABHA director positions and authorized EFT employee. Be prepared to provide their name, address, SSN, date of birth and title. Board of directors do not need to supply SSN number.
- Accreditation information – name of accrediting body and current dates of accreditation.
- Accurately answer questions about any current, past and/or pending sanctions, adverse actions and criminal backgrounds for your ownership, managing staff, board of directors and clinical staff. Failure to disclose is grounds for denial.
- Contact information for your billing agent, if applicable.
- List of all LME/MCOs that you have a contract with, if applicable.
- Copies of all facility and/or service licenses for sites credentialed by Alliance, if applicable.
- Ensure secretary of state document filings are up to date (corporate address), if applicable.
- Submit a copy of the certificate of insurance for professional liability from the organization’s insurance carrier that meets the minimum amounts of $1,000,000/$3,000,000. For organizations that provide outpatient and/or psychiatric services, each individual clinician must be listed, by name, on the organization’s certificate of insurance for professional liability.
- Submit certificate of insurance for automobile liability insurance for company vehicles, and employee (include contracted employees) vehicles that are used to transport individuals. ($500,000 per person and per occurrence or has a combined single limit of $1,000,000).
- Submit certificate of insurance for workers’ compensation from the organization’s insurance carrier that meet the minimum amounts of not less than bodily injury by accident $100,000 each accident/bodily injury by disease $100,000 each employee/bodily injury by disease $500,000 policy limit.
- Submit certificate of insurance for general liability from the organization’s insurance carrier that meets the minimum amounts of $1,000,000/$3,000,000.
- Alliance Health’s name and address should be listed as the certificate holder.
- Submit a current LP roster (if applicable).
- Submit an annualized budget, and most recent certified audit or the most recent board-approved financial statement.
- For-profit entities to submit a CFO statement of financial capacity.
- Prepare site specific information that includes contact information, service information and emergency coverage information. Referral contact information should be provided for each site location.
- Submit a listing of CABHA personnel and their individual contact information (if applicable).
- Policies and procedures that reflect the implementation of all state standards. Must contain a table of contents that includes page numbers references.
- If there are no changes to previously submitted policies and procedures, a signed and dated attestation that indicates no change in the policy and procedures that was submitted with your original application must be included.