Provider Outreach to Members

Some providers are encouraging patients to sign up for managed care (i.e. the Standard Plans) and listing the health plans they have contracted with to help patients with health plan selection. We welcome this engagement from our providers, but please note that not all Medicaid members are moving to managed care now. We understand receiving letters or other information from providers to sign up for a health plan is causing some confusion for our members who are not required to sign up at this time.

Members who are not required to sign up include those on the Innovations Waiver or people receiving intensive mental health or substance abuse services.

If you hear from your provider conducting outreach, we encourage you to call the NC Medicaid Enrollment Broker at 833-870-5500 (TTY: 833-870-5588). The enrollment broker can tell you if you are required to sign up for Medicaid Managed Care at this time and can help you with making an informed choice if you are.

North Carolina Treatment Outcome & Program Performance System (NC-TOPPS)

Breadcrumb

The North Carolina Treatment Outcomes and Program Performance System (NC-TOPPS) is the program used by the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services (DMH/DD/SAS) to measure the quality of substance abuse and mental health services a consumer receives and how the service impacts their life.

The LME/MCO-Provider Contract and Memorandum of Agreement obligates a provider agency to participate in the NC-TOPPS program and requires them to complete a NC-TOPPS interview for all identified consumers within a specified time frame.

This valuable data is used to:

  • Develop treatment plans that are individualized to meet the specific needs of each consumer.
  • Maintain quality throughout the service system by identifying inadequate services and outcomes.
  • Aids Local Management Entities-Managed Care Organizations (LME/MCOs) during their monitoring of service outcomes.
  • Provides data for meeting federal performance and outcome measurement requirements, which allows North Carolina to evaluate its service system in comparison to other states.

Additional details of provider agency performance requirements can be found in the LME/MCO-Provider Contract or Memorandum of Agreement signed by each provider agency and the LME/MCO.

NC-TOPPS at Trillium Health Resources:

Getting Started with NC-TOPPS

NC-TOPPS Enrollment Form:

NC-TOPPS Training Materials:

  • NC-TOPPS Quick Start Guide – Provides information for setting up a new user account, links to NC-TOPPS related websites and NC-TOPPS helpdesk, data entry and how to use the data for reports and tracking, and where to access the interview form.
  • NC-TOPPS Implementation Guidelines FY 2020-2021 – This is a 19-page explanation of the NC-TOPPS system that outlines the Rules, Regulations and Practices for NC-TOPPS
  • Services that require NC-TOPPS - A listing of all service codes and diagnosis that require an NC-TOPPS.
  • NC-TOPPS Super user Tools Guide – An excellent reference for all super users that explains the role of super users, how to instructions, approve and remove users, and change consumer’s QP.
  • NC-TOPPS Questions (July 2020) – This listing of questions has been compiled by the NC-TOPPS staff. It can help providers answer many of their questions.

NC-TOPPS Report & Data:

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If you find any wrong or out of date information on our pages, we want to know. Please email Info@TrilliumNC.org with any corrections.