Trillium medicaid provider phone number. The Alternate Contact should not be a PCS Provider. 1915 (i) services are not available with Standard Plans. If you wish to choose a dierent PCP, contact Trillium at 1-877-600-5472. All providers must be credentialed before they can be added to our network as a participating provider. Medicare Provider Training EPSDT Provider Information and trainings Trillium is committed to providing preventive health screenings and improving the overall health of children enrolled in our health plans. org. Complete this form to change your TCM Provider. This list does not contain primary care, behavioral health or most ancillary care, as it is focused on provider taxonomy. Trillium is committed to simplifying the administration of health insurance so our providers can devote their attention to providing health care. Find a psychiatrist in Stukel, Oregon. Program management through stakeholder collaboration, effective use of drug rebates and careful selection of drugs on a Preferred Drug List (PDL) are just three ways NC Medicaid provides access to For more than 20 years, Wellcare has offered a range of Medicare products, which offer affordable coverage beyond Original Medicare. Providers may discuss questions with Trillium Provider Services Representatives regarding amount reimbursed or denial of a particular service. Available services include basic Medicaid services for North Carolina, plus some additional services for more serious behavioral health or I/DD conditions. Behavioral Health Services Physical Health Services Authorization Calculator Service Definitions Service Definitions Rapid Response Team is billed in lieu of Mobile Crisis. This decision is called an “adverse benefit determination. You can search for more than one filter, like “Health Plan” and “Specialties” under the Specialties list. BEHAVIORAL HEALTH OUTPATIENT MEDICAID PRIOR AUTHORIZATION FORM Complete and Fax to: 1-833-505-1300 Request for additional units. The Wellcare By Trillium Advantage Provider and Pharmacy Directory is a list of Primary Care Providers (PCPs), physicians, hospitals, drug stores, and other healthcare providers that are available to you. Check to see if a pre-authorization is necessary by using our Pre-Auth Check Tool. Medicare Provider Training Mar 2, 2014 · Trillium's Provider Network We are proud to work together with a network of incredible health care providers to offer the right, individualized care for the people we serve. PROVIDERS - Click on the Providers tab above to enter the Provider Portal. Our collective community-based approach focuses on meeting people’s unique needs. Trillium will enter authorization requests received via email for the provider agency. Or, if you are searching for a doctor for your child, and he or she is on Trillium OHP, choose Medicaid/OHP. For more information, please view the State-Funded Recipient Handbook. To change your TCM provider, contact your Tailored Plan who can give you information on certified TCM providers by p Beneficiaries on the Innovations and TBI waivers can choose the care coordinator they have now as their TCM provider or choose a different TCM provider. This guide should be used together with Trillium's Provider Manuals, Communication Bulletins, and guidance from the Department of Health Benefits, the Division of Mental Health and NC Medicaid Management Information System (MMIS). Trillium Community Health Plan providers are contractually prohibited from holding any member financially liable for any service administratively denied by Trillium Community Health Plan for the failure of the provider to obtain timely authorization. e Congregate Care settings) can be billed through the Trillium Physical Health Secure Provider Portal if they are part of the physical health service benefit. A hotline is available for making such complaints. Complete if requesting a Non-Medical Change of Status. Dec 30, 2025 · Contact Trillium at 877-600-5472 or use their online provider search tool at TrilliumOHP. Here you will find pharmacy address, phone number (s) and a link to the pharmacy website if available. org Trillium requires all providers to be enrolled in NC Tracks and credentialed to provide services to Medicaid beneficiaries. Approved In Lieu of Services Vaya Health Attachment L. The program is consistent with industry-wide efforts to both ensure clinically appropriate care and manage the increasing utilization of these services. NC Medicaid Direct behavioral health services will be reimbursed by Trillium. • Will Trillium accept Provider Tailored Plan Trainings from another MCO? Home Welcome to NCTracks, the multi-payer Medicaid Management Information System for the N. Sep 1, 2024 · Trillium will pay for HCI services provided for Medicaid covered services. Department of Health and Human Services (N. For information related to claim corrections, review the CCH Billing Manual. Trillium office Business Holiday Closing days Please note: Our Behavioral Health Crisis Line is available 24 hours a day, seven days a week and will remain open on holidays when our administrative offices are closed. We will try to keep you with your current provider, if they are in our directory. Through Tailored Care Management (TCM), Trillium Medicaid members will have a single designated care manager supported by a multidisciplinary care team. This includes contracting, physical health claims processing, physical health authorization review, physical health provider engagement, and more! Trillium Community Health Plan, Wellcare and Health Net Oregon Announce Medicaid, Medicare and Commercial Provider Contract with PeaceHealth 03/11/24 Trillium, Wellcare By Health Net, Wellcare By Trillium Advantage, and Health Net Oregon announced that they have contracted with PeaceHealth as part of their provider networks. Access your secure account information for Trillium Community Health Plan online through our health care portal for members and providers. Section F: Change of Status: Non-Medical. Trillium contracts with physicians, facilities, and other allied providers to ensure we have an adequate provider network which is essential for the delivery of healthcare services to our members. For more information about these agencies, contact us at the Member and Recipient Services at 1-877-685-2415. If my provider is out of Trillium's network, what can my provider do to help me? Find out if you need a OHP pre-authorization with Trillium Community Health Plan's quick and easy pre-authorization check. MOST PEOPLE GET MEDICAID SERVICES THROUGH A HEALTH PLAN You have access to a group of providers, 24-hour Nurse Line and can see your doctor as needed. You can visit a provider in our network before contacting Trillium. com to learn more about health care providers in Trillium’s network. If you have dental-only benefits through the Veteran or COFA Dental Programs, you can get help paying for rides to dental appointments. Only services at a sub-site: Select the desired sub-site For contract questions and concerns, please contact Network Services Support at NetworkServicesSupport@ TrilliumNC. Apr 15, 2024 · Emergency Department (ED) and Out of Network (OON) Providers may submit paper claims to: Claims Department, 5200 P. ) and we will help you find the type of services you need and Trillium requires all providers to be enrolled in NC Tracks and credentialed to provide services to Medicaid beneficiaries. NC Medicaid Managed Care offers different health plan options. Our Member & Recipient Services is also available Monday-Saturday, 7:00 am - 6:00 pm, regardless of administrative holidays. 7200. If the patient is enrolled in Medicaid Direct, the service will be billed to NC Medicaid. Trillium has a waitlist for those state-funded recipients who are waiting to receive Care or Case Management. To assist providers, we offer a list of contracted specialists, sorted by specialty and county. If the patient is enrolled in a Trillium Tailored Plan, the service will be billed to Carolina Complete Health. org and ask to contract with Trillium. NEW PROVIDER QUICK GUIDE Transforming Lives. ” You will receive a letter from Trillium about this. When Tailored Plans launch, providers and hospitals will no longer be reimbursed by NC Medicaid Direct for most Physical Health services rendered to Tailored Plan members. Sometimes Trillium may not agree with a treatment decision your provider makes for your services. Building Community Well-Being. Get new member guidance. Find out if you need a Medicaid pre-authorization with Trillium Community Health Plan's quick and easy pre-authorization check. This service is free to you. Emergency Preparedness Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule establishes national emergency preparedness requirements Annual plan submission of each facility to Trillium Monthly topics shared in the Network Communication Bulletins Trillium Health Resources (Trillium) Billing Guide will provide information to support your claim processes. Non-Emergency Medical Transportation (NEMT): Trillium has contracted with Modivcare to provide non-emergency medical transportation to help you get to and from your appointments for Medicaid-covered care. Email Provider Support: NetworkServicesSupport@TrilliumNC. Tag #growwithwix to get featured. Call Trillium Provider Support Service Line at 855-250-1539 to be connected to the physical health utilization management team. Call 1-919-881-2320. DHHS). A provider may claim a hardship payment via email communication to the Financial Hardship team at TrilliumFinance@TrilliumNC. Trillium Health Resources PO Box 240909 Apple Valley, MN 55124 If you have questions, please contact the Provider Support Service Line at 1-855-250-1539. Nov 10, 2025 · Find A Doctor Or Pharmacy Search for doctors, hospitals, and specialists near you. We will incorporate those TRILLIUM AND EASTPOINTE FINAL CONSOLIDATION AGREEMENT Trillium Health Resources and Eastpointe Human Services, which was already in the process of merging with Sandhills Center came together in mutual agreement to build on their collective strengths and administer state and Medicaid-funded Mental Health, Substance Use Disorder, (SUD),Intellectual Developmental Disabilities(I/DD), Traumatic PROVIDER INFORMATION (Required): COMPLETE THIS SECTION ONLY IF THERE IS A CHANGE (PLACE AN X IN THE APPROPRIATE CHECK BOX) CHANGE IN KEY PERSONNEL (Ex. Dec 4, 2025 · Oregon Health Authority is working to manage a transition that will shift 96,000 Medicaid members in Lane County from PacificSource to Trillium. After the next page is fully loaded, click the Quick Name Search to search by entering the Practitioner or Provider Name. Beginning Jan. Policies, 7. RECIPIENTS - Click on the Recipients tab above to enter the Recipient Portal. If you have any questions, please contact Provider Relations. If we approve the request, we will send a letter to tell the beneficiary when they will start getting Medicaid services through a Tailored Plan. Connect with care. The Trillium provider portal complies with all CMS and HIPAA specifications regarding patient information and internet How to Get the Care You Need There are several ways to find and get services for health care. . For Beneficiaries living in, and those seeking admission to, an ACH, enter the facility’s address and phone number. m. We send timely messages through our email distribution via Constant Contact so please be sure at least one staff person in your office signs up to receive these updates. For additional support, please contact Trillium Provider Services at 877-600-5472. NC Innovations is a Medicaid Waiver program for individuals with intellectual disabilities/ developmental disabilities who prefer to receive long-term services and supports in their home or community, rather than an institutional setting. Non-EVV: Other PCS services (i. Providers and others can suggest recipients be added to the list; please call Trillium at 1-877-685-2415 if you feel you need to be placed on this list. We offer medication management, psychiatric evaluation and psychotherapy. This is an opportunity to remain “in-network” for members who are eligible for a Tailored Plan. T o report concerns or to get more information, please contact Member Services at 541- 485 -2155; Toll Free: 1- 877 -600 -5472; TTY: 1- 877- 600 -5473, Monday through Friday, 8:00 a. Trillium keeps the provider network apprised of new information and procedural changes on an ongoing basis to ensure providers are up-to-date and understand revised expectations as they happen. Tailored Care Management for Providers Provider-based care management promotes integrated care and offers Trillium members choice in how they receive care management. If the service is provided by qualified or certified staff, providers may bill Trillium by adding HCPC code T1013 to the claim. org due to delays in claims processing or other operational concern. Trillium utilizes the Provider Enrollment File and/or the NC Tracks Operations Portal to validate enrollment and credentialing. Provider Support Service Line - 855-250-1539 Administrative & Business Matters - 866-998-2597 TrilliumHealthResources. Contact a Trillium Community Health Plan Provider Service Representative at 541-485-2155 (Toll Free 877-600-5472). Member eligibility, benefit plans, codes in provider contracts, and other details may impact payment. Sandhills Center Attachment L. their Medicaid card. Medicaid members have a right to tell us if they don’t agree with this adverse benefit determination and can appeal the decision. Some members can choose OHP Open Card or Trillium: Some members can get OHP Open Card instead of Trillium. Trillium’s provider portal allows secure online access to information stored on Trillium data systems. Rides will be arranged with the nearest appropriate provider. org or call Trillium’s Provider Support Service Line at 1-855-250-1539. Call the one listed on your health plan ID card, and ask if you have Tailored Care Management: Don’t see your plan? Tailored Care Management is only available with Tailored Plans or NC Medicaid Direct; it is not available with Standard Plans or EBCI Tribal Option. pdf PDF • 1. 545. Provider Enrollment Operational Information & Forms Innovations Waiver - Relative/Guardian as Direct Service Employee Trillium NC SNAP Training Eligibility and Registration Forms Non-Covered State Medicaid Plan Services Request Form for Recipients under 21 Years Old Regional Referral Form for Admission to a State Psychiatric Hospital or ADATC Apr 15, 2025 · Instructions Use this form to submit a Claim Reconsideration (Level I) or Claim Grievance (Level II) through the Secure Provider Portal or by mail. 1 day ago · » Provider Links Log on to the Secure Provider Web Site Enroll as a Medicaid Provider Submitting Supporting Documentation Provider Enrollment Tracking Addictions and Mental Health Services Oregon Health Plan Resources for The Aging and People with Disabilities Jun 1, 2016 · Effective June 1, 2016 (Updated March 30, 2023) Trillium entered into an agreement with National Imaging Associates, Inc. Trillium offers affordable Oregon Medicaid and health insurance. NEMT is for Medicaid members on the Tailored Plan Nov 7, 2018 · Trillium Trillium. This service is connected to the Emergency Department or Inpatient unit to rapidly respond to and transition members with mental health, intellectual or developmental disabilities or substance use disorders out of the ED or Inpatient care into Find out if you need a OHP pre-authorization with Trillium Community Health Plan's quick and easy pre-authorization check. As a courtesy to our patients, we will submit claims to your insurance carrier for you. Here is a list of insurance carriers accepted by Clear Choice Dermatology. If you clicked something by mistake, click the item again to unselect it. Enter the Facility License # and Date, if applicable. Approved In Lieu of Services Trillium Health Resources Attachment L. Existing Authorization Trillium will use the standard authorization time frames when processing these requests. Enter the Practitioner or Provider Name and click Search. " Mar 2, 2026 · Trillium Community Health Plan HRSN Provider Directory Last updated: March 2, 2026 For additional support, please contact Trillium Provider Services at 877-600-5472. Other vendors can call Administrative & Business Matters at 1-866-998-2597 (Toll-Free) for general questions and business matters. After we get the signed form: NC Medicaid will review this request. Claim Ticket System: ClaimsSupport@TrilliumNC. Trillium's hardship process supports our providers when they have reached a financial hardship status for various reasons. Partners Health Management and Trillium Health Resources maintain open networks for all physical health providers and enter into good faith contracting efforts with any willing provider of physical health services via a partnership with Carolina Complete Health. Jan 8, 2026 · Trillium Health Resources, 1-877-685-2415, TTY: 711 Vaya Health, 1-800-962-9003, TTY: 711 Don’t see your plan? 1915 (i) services are only available with Tailored Plans, NC Medicaid Direct or Eastern Band of Cherokee Indians Tribal Option. Main Contact, CEO, Director, Survey Contact, Information Change) ADD Botox injections for spasticity is a physical health procedure. Services are available for Medicaid members and state-funded recipients. Trillium Community Health Plan, Wellcare and Health Net Oregon Announce Medicaid, Medicare and Commercial Provider Contract with PeaceHealth Trillium, Wellcare By Health Net, Wellcare By Trillium Advantage, and Health Net Oregon announced that they have contracted with PeaceHealth as part of their provider networks. Provider & Pharmacy Directory Information If you need help finding a network provider, dentist and/or pharmacy or would like a Provider/ Pharmacy Directory mailed to you, please contact Member Services. These Medicaid health plans offer Tailored Care Management. If we need more information, we will contact the beneficiary’s doctor, therapist or other healthcare provider staff. Click on the drop-down arrow beside the name of each health plan for contact information and resources specific to each plan. Some providers in behavioral health, already credentialed with PacificSource, say they were denied entry into Trillium’s network ahead of the switch and said they still lack clear answers. 1, 2022, our affiliated Medicare product brands, including Allwell, Health Net, Fidelis Care, Trillium Advantage, and ‘Ohana Health Plan transitioned to the newly refreshed Wellcare brand. TRILLIUM OUTPATIENT PRIOR AUTHORIZATION Expedited Medicare Requests Call: 1-844-867-1156 Fax Other Requests to: (844) 371-7765 Medicare (866)-703-0958 Medicaid Request for additional units. See contact information for all Medicaid health Nov 20, 2025 · Help you manage chronic conditions, like diabetes Be your main point of contact for all things Medicaid And more! Learn more about how Tailored Care Managers can help you. - 6 p. C. May 15, 2019 · KYHealth-Net - KYMMIS KYHealth-Net Trillium will make reasonable changes to policies, practices, and procedures by talking with you about your needs. When you call for an appointment, tell your provider’s office that you need an interpreter and the language you need. See if you qualify. Not sure who 864K Followers, 200 Following, 2,566 Posts - Wix (@wix) on Instagram: "The all-in-one website builder for businesses, entrepreneurs and creatives. Locate your Provider Engagement Representative by selecting your region below. Provider also can submit questions via this email. Resources Trillium is working with Carolina Complete Health to build and support the physical health provider network. (NIA), to manage a suite of Medical Specialty Solutions services effective June 1, 2016. You need to choose a Dental Care Organization (DCO). Please call Trillium Member and Recipient Services at 1-877-685-2415 for a printed copy, if you need to verify any information listed for providers, or need any assistance. Medicaid Direct Services and State Funded Services: Providers who serve beneficiaries who are excluded or delayed populations from Medicaid managed care, will continue to receive Behavioral Health and I/DD services through Trillium Health Resources. Box 8002 Farmington, MO 63640-8002 Medicaid Tailored Plan Behavioral Health and State Benefit should be mailed to: 901 S New Hope Road Gastonia, NC 28054 Your Transportation Benefits If you are a member of the Oregon Health Plan (OHP and Medicaid), you can get help paying for rides to medical, dental, and behaviorial health appointments. If you suspect a doctor, clinic, hospital, home health service or any other kind of health provider is committing Medicaid fraud, report it. 1-877-367-1332 | 1-541-338-2936. You can ask for help through Medical Transportation Management (MTM). How to Find Trillium Community Health Plan Providers in this Directory You can use this directory to find a primary care provider (PCP), specialist, facility, or hospital by name, location, or type of practice. See contact information for all Medicaid health plans. to 5 :00 p. Achieve your vision with Wix. For assistance or questions about the redetermination / reconsideration process, contact Trillium Community Health Plan Monday through Friday 8am to 5pm at (877) 600-5472 or (541) 485-2155. Trillium's process supports providers from start to finish through the process. Trillium contracts with physicians, facilities and other allied providers to ensure we have an adequate provider network which is essential for the delivery of health-care services to our members. Approved In Lieu of Services Contract #30-2022-007-DHB MD PIHP Amendment Number 2 Contract #30-2022-007-DHB MD PIHP Amendment Number 5 (8) (9) Jan 13, 2014 · About the Pharmacy Program The North Carolina Medicaid Pharmacy Program offers a comprehensive prescription drug benefit, ensuring low-income North Carolinians have access to the medicine they need. O. You may be eligible for Tailored Care Management if you have NC Medicaid with Alliance Health, Partners Health Management, Trillium Health Resources or Vaya Health. You can call Member and Recipient Services at 1-877-685-2415 (Monday - Saturday, 7 a. Get covered with Trillium Community Health Plan today. REQUEST FOR A CHANGE OF TAILORED CARE MANAGEMENT (TCM) PROVIDER Your Tailored Care Manager is the main person who assists you in managing your care. If you have questions or comments, or would like to request further information about Trillium Health, you can reach us at 585. Provider Resources Trillium Community Health Plan (Trillium) provides the tools and support you need to deliver the best quality of care. PacificSource Community Solutions offers Medicaid plans in several regions of Oregon and works to improve community health. This service does not replace the first responder responsibilities of other enhanced providers. Trillium providers, vendors, staff and patients have the right to report concerns and complaints about Trillium. The Trillium Provider Directory lists the languages that providers have identified that one or more of their staff members speak. LME/MCO Directory LME/MCOs, or Local Management Entity/Managed Care Organizations: manage NC Medicaid Tailored Plans coordinate certain services for NC Medicaid Direct beneficiaries coordinate certain services for EBCI Tribal Option members There is one LME/MCO for each county. In-network insurance plans are accepted. Nov 18, 2022 · CAN BENEFICIARIES OPT-OUT OF TCM SERVICES? cause” (with an approved reason). Trillium prioritizes treatment in the most inclusive setting, attention to the whole person, and concentration on an individual's strengths. Nov 20, 2025 · Help you manage chronic conditions, like diabetes Be your main point of contact for all things Medicaid And more! Learn more about how Tailored Care Managers can help you. Specialized staff can assist with your questions, or will contact the appropriate department to answer all inquiries. Providers can help you find a provider in Trillium’s network by calling Trillium at 1-877-685-2415 or the NC Medicaid Enrollment Broker at: 1-833-870-5500. Our call center team will be happy to direct your call to the appropriate group. Dec 11, 2025 · This page provides a listing of NC Medicaid provider health plan contacts and resources. Jun 3, 2018 · Provider Support Services: 1-855-250-1539. 08 MB - November 07, 2018 Contact Information NC Department of Health and Human Services 2001 Mail Service Center Raleigh, NC 27699-2000 Provider Enrollment Operational Information & Forms Innovations Waiver - Relative/Guardian as Direct Service Employee Trillium NC SNAP Training Eligibility and Registration Forms Non-Covered State Medicaid Plan Services Request Form for Recipients under 21 Years Old Regional Referral Form for Admission to a State Psychiatric Hospital or ADATC 1-855-250-1539 or email NetworkServicesSupport@TrilliumNC. If you have questions, call Trillium Member Services for more information at 1-877-685-2415 (TTY users should call 711). For urgent requests or immediate service, please call Member Services toll free number at 1-877-685-2415. Feb 1, 2018 · Provider Portal The Trillium Provider Portal serves as a fast and easy way to check eligibility, prior authorizations (PAs), and claims for dates of service after 2016. You can also call Trillium at 877-600-5472 (TTY: 877-600-5473). Your Trillium Health Resources (Trillium) Quick Reference Guide Keywords Used in This Handbook How NC Medicaid Direct Works How the LME/MCO Works Help From Member and Recipient Services For People with Hearing, Vision or Speech Disabilities Your Medicaid ID Card How to Choose or Change Your PCP Out-Of-Network Referrals and Out-Of-Network Providers Trillium is dedicated to supporting the provider community by sharing resources to assist members with accessing care. Please refer to the provider manual or call the Provider Support Service Line at 1-855-250-1539 for more information. We will send you a letter within two weeks of joining Trillium that tells you which PCP you are assigned to. ylfoul ycj rrxun vaoekw nypczxq xunxv pcdaqx rxhpmd xhjai xfyd