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NC Medicaid has changed the start date for Tailored Plans to October 1, 2023. Until then people will keep getting services the way they do now.

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Tailored Plan Provider Training

As part of the Tailored Plan requirements, Alliance offers select trainings to all network providers.

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The following trainings will eventually be housed in a Learning Management System (LMS) that will be accessible in the Provider Portal. Individual trainings are still in development.

Provider Training Overview

As part of the Tailored Plan requirements, we are required to offer the following trainings (which may have reciprocity with other plans):

  • Annual EPSDT/Into the Mouth of Babes
  • Fraud, Waste, Abuse
  • Population Health
  • Infection Prevention and Control
  • Tobacco Cessation/Tobacco-Free Campus

Provider Onboarding

Additionally, all providers are strongly encouraged to participate in an Alliance-specific orientation program anticipated to begin in January 2023. This will include critical information regarding, for example, claims and UM.

What do providers need to do?

Alliance provider entities are requested to submit information about up to three identified staff. These identified staff will receive notification from the Alliance Learning Management System regarding the staff that will take or submit the provider training certificates through the Alliance Learning Management System. This will allow efficient tracking of the trainings and ensure providers are credited for completing the trainings.

On-Demand Trainings

While designated staff are encouraged to take the interactive trainings above, anyone who wishes to view the basic training materials in the form of a recorded video may do so below.

Alliance Onboarding Orientation

  • Alliance Organization Chart
  • Medicaid Managed Care
  • Tailored Plan Quality Strategy
  • Tailored Care Management Overview
  • Provider Manual Overview
  • Advanced Directives
  • Medical Necessity Criteria
  • Clinical Practice Guidelines
  • Screening Tools
  • Claims System and Claims Resources Overview
  • Website Overview
  • Training Calendar
  • Benefit Plan
  • Value Added Services
  • Enrollment (State funds only)
  • Grievances and Appeals
  • Submitting Prior Auth Requests
  • Provider Helpdesk
  • Roles of Provider Relations Specialist
  • Housing Resources
  • Better at Home
  • Value-Based Programs
  • Cultural Competency Plan
  • Disease Management
  • Fraud, Waste and Abuse

Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

  • Overview/Background of EPSDT
  • EPSDT Criteria and Features
  • Requesting covered and non-covered EPSDT
  • The American Academy of Pediatrics Recommendations for Preventative Pediatric Care

NC Tobacco-Free Campus

  • Overview of NC Tobacco-Free Campus
  • Tobacco-Free Campus Requirements
  • Tobacco-Free Campus Resources

Infection Control and Prevention

  • Overview of the resources available through the Statewide Program for Infection Control and Epidemiology (SPICE)
  • Proper procedures related to donning and removing PPE
  • Proper handwashing procedures

Population Health

  • Diabetes Prevention
  • Pregnancy Intendedness
  • Healthy Weight
  • Opioid Misuse Prevention and Treatment Program
  • Tobacco Cessation (Medicaid and State funded providers will receive this training)

Into the Mouth of Babes (IMB)

  • Into the Mouth of Babes (IMB) program training overview
  • How to access IMB Toolkit
This page was last reviewed for accuracy on 02/06/2022