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NC Medicaid Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans will launch July 1, 2024. Choice period ends on May 15, 2024. Please call to select your PCP. Find PCPs available in our health plan.

Effective February 1, 2024, citizens of Harnett County are being served by Alliance Health. Access more information for health plan participants or for providers.

Alliance Health
Provider Support: 855-759-9700
Provider Portal Log In AllianceHealthPlan.org

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Home / Services / Medicaid B: Individual Supports TCL

Medicaid B: Individual Supports TCL

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About

Coverage Information Icon

Medicaid Direct (Medicaid B)

Diagnosis Group(s) Information Icon

Mental Health, Substance Use

Age Group(s) Information Icon

Adults 18+, Child

Reference Documents

Authorization

Submission Requirements Information Icon

Initial:

  • Service Authorization Request (SAR)
  • Person Centered Plan (PCP) with Service Order
  • Daily Living Activities-20 (DLA-20)

Concurrent:

  • Service Authorization Request (SAR)
  • Updated Person Centered Plan (PCP)
  • Daily Living Activities-20 (DLA-20) Update

Service Definition Authorization Parameters Information Icon

Initial & Concurrent:

  • 6 units for 6 months

Request Prior Approval from Alliance Health

Service Codes & Descriptions

  • T1019 U4 22 Z1- Individual Supports- TCL

Alliance Statement of Work

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.