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.
A self-managed system relies on educated providers who understand and operate in tandem with Trillium Clinical Objectives and the Clinical Design Plan.
Our goal is to develop a system where the structure, requirements, and expectations are so well known, that extensive management and intervention by Trillium is not required.
This model includes the engagement of our Providers in the management of the system and relies on their involvement in the development of strategies to meet quality and performance goals and develop solutions for systemic problems. Providers participate with Trillium through the Trillium Provider Council and the Clinical Advisory Committee. Provider participation in the ongoing operations of the Trillium system is critical in the efficient and effective identification of strategies that will ensure success in achieving our goals.
Our joint purpose is to assure easy access, appropriate, high-quality services for members, and the elimination of ineffective and poor outcome services and practices.
To that end, Trillium Network Providers are required to know and are monitored for compliance with, all applicable NC DHHS Clinical Coverage Policies. Additionally, Providers are expected to maintain and/or advance the quality of services through the demonstration of practice consistent with pertinent Clinical Guidelines and Best Practices.
Trillium welcomes feedback from providers about Clinical Practice Guidelines used in their current treatment setting. Feedback and recommendations will be taken into consideration for future features/highlights on our website. Feedback or recommendations may be sent to QMinfo@TrilliumNC.org.
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