Tailored Plan Policies

Alliance shall use this Provider Credentialing and Re-credentialing policy to decide whether to contract with Medicaid, Health Choice or State-funded Services enrolled providers in accordance with the standards contained in this policy. - This page will be edited down and link to the full policy.

A description of Alliance’s good faith effort to contract for Medicaid, NC Health Choice and State-funded services with Essential Providers and with any willing physical health, pharmacy or Indian Health Care Provider in the development and management of its network for physical health and pharmacy services.

The Alliance Health Utilization Management Program Policy is still in development. Once completed, you'll find it on this page.

In Lieu of Services (ILOS) are services that have been approved by NCDHHS to be medically appropriate and cost-effective substitutes for covered services or setting under the State Medicaid Plan.