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Provider News

This section provides quick access to operational information and the latest news affecting the Partners’ Provider Network

Provider Communication Bulletin #171

In This Bulletin: Partners Office Closure Provider Information Sessions: NC CWTIA Update: TBI Allocation Available New Guidance on Metformin Current Service Needs HCBS Compliance Scenarios Clinical Coverage Policies IRIS Incident Reporting Reminders Claims Information Recent Provider Alerts Training Resource and Collaborative (TRAC) Community Training PDF Version > Partners Office Closure Partners Health Management offices will

Provider Alert: ProAuth Account Assistance

Issued: December 3, 2025 We are aware that some users are experiencing issues with the ProAuth website, such as the site not loading or only displaying a white screen. To resolve this, please follow the steps below: Clear your internet browser cache. Remove any old bookmarked links/URLs and update the bookmark after the site is

Provider Communication Bulletin #170

In This Bulletin: Thanksgiving Office Closure Clozapine Management Education Resource Current Service Needs Providers Needed for Court-Ordered Evaluations HCBS Assessment Requirements Update Understanding Program Integrity Paybacks Transition of Care Updates Partners NC-TOPPS Updates Clinical Coverage Policies IRIS Incident Reporting Reminders Claims Information Recent Provider Alerts Training Resource and Collaborative (TRAC) Community Training PDF Version >

Provider Alert: Utilization Management Update: Transitional Youth Services (TYS) In Lieu of Service

Issued: November 5, 2025 What is happening?   Effective Oct. 1, 2025, Partners Health Management launched a newly approved In Lieu of Service (ILOS) called Transitional Youth Services (TYS) for Tailored Plan members. This service, formerly known as Young Adults in Transition (YAT), was previously discontinued by the N.C. Department of Health and Human Services (NCDHHS).

Provider Alert: Utilization Management Update: Member Specific Rates (Enhanced Rate Requests)

Issued: Nov. 4, 2025 Effective Oct. 1, 2025, Partners Health Management implemented the NC Medicaid Rate Reductions changes made by the Division of Health Benefits (DHB). In conjunction with these changes, Partners has made updates to the criteria for new Member Specific Rate Requests (Enhanced Rate Requests). What is Happening? Effective Nov. 1, 2025, Partners

Provider Communication Bulletin #169

In This Bulletin: Partners Office Change Provider Council Date Change GLP-1 Medication Updates Native American Heritage Month Celebration NC-TOPPS Focus Pilot Clinical Coverage Policies IRIS Incident Reporting Reminders Claims Information Recent Provider Alerts Training Resource and Collaborative (TRAC) Community Training PDF Version > Partners Office Change Partners Health Management is relocating its Statesville, N.C., office

Provider Communication Bulletin #168

In This Bulletin: ID Cards and PCP Changes PDL Changes Coming Oct. 1, 2025 Additional Outpatient Therapy NC-TOPPS Focus Pilot GCQI Provider Participation Opportunity Clinical Coverage Policies IRIS Incident Reporting Reminders/strong> Claims Information Recent Provider Alerts Training Resource and Collaborative (TRAC) Community Training PDF Version > ID Cards and PCP Changes Partners reminds providers of

Provider Communication Bulletin #167

In This Bulletin: Current Service Needs NC-TOPPS Kudos Corner is Live! Person-Centered Practice Learning Collaborative Clinical Coverage Policies IRIS Incident Reporting Reminders Claims Information Recent Provider Alerts Training Resource and Collaborative (TRAC) Community Training PDF Version > Current Service Needs Partners is seeking additional providers across our 15-county service area to fill service gaps and

Provider Communication Bulletin #165

In This Bulletin: Partners Health Management Updates Providers Needed for Court-Ordered Evaluations TBI Funding Applications Deadline Extended Tobacco-Free Campus Deadline Extended Peer Support Services: Supporting Patient Engagement Insomnia Management Prescribing Guidance Process for Successful Pharmacy Requests CBT Learning Community: Now a Monthly Training Series IRIS Incident Reporting Reminders Claims Information Recent Provider Alerts Training Resource

Medicare Crossover Claims

Issued: June 10, 2025 Partners Health Management is now processing Medicare Crossover claim files received from NCTracks for dual-eligible members (Medicare and Medicaid coverage) in our coverage area. What do providers need to do? Providers with dual-eligible members will only need to directly submit claims when the following applies: Medicaid requires a different billing format