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NC Medicaid has changed the start date for Tailored Plans to April 1, 2023. Until then people will keep getting services the way they do now. Learn about town hall meetings!

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Site Enrollment Form
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Credentialing and enrollment
/ Last uploaded 05-10-2022
Site Enrollment Form
Form to be used as part of site enrollment for specific services.
Form to be used as part of site enrollment for specific services.
Inpatient Out of Network SAR
Inpatient Out of Network SAR
Authorizations and SARs
/ Last uploaded 05-10-2022
Inpatient Out of Network SAR
For providers not in our network who wish to obtain a single case agreement ...
For providers not in our network who wish to obtain a single case agreement to provide services to a Medicaid recipient who has Alliance Medicaid
Short-Term Assistance Invoice
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Other Forms and Documents
/ Last uploaded 05-10-2022
Short-Term Assistance Invoice
This is the short-term group home assistance invoice template from NC DHHS for short-term ...
This is the short-term group home assistance invoice template from NC DHHS for short-term assistance funding.
Sample Service Plan
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Other Forms and Documents
/ Last uploaded 05-10-2022
Sample Service Plan
This is a NC DHHS approved template service plan used for all non-Medicaid C ...
This is a NC DHHS approved template service plan used for all non-Medicaid C waiver services
Tailored Plan Member Handbook
Tailored Plan Member Handbook
Tailored Plan Materials
/ Last uploaded 07-25-2022
Tailored Plan Member Handbook
NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan Member Handbook
NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plan Member Handbook
May 2022 Minutes
May 2022 Minutes
Board Minutes and Agendas
/ Last uploaded 06-09-2022
May 2022 Minutes
Agenda for the May 2022 Alliance Health board meeting
Agenda for the May 2022 Alliance Health board meeting
This page was last reviewed for accuracy on 07/06/2021