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Interested in joining our network? Our providers help our members achieve wellness and independence by providing life-changing care and support. As a Cardinal Innovations provider, you’ll receive:
  • Timely payments
  • Training resources
  • Clinical plans and support
  • Opportunities for outreach and advocacy
  • Your Network Relations Provider Assignment to provide or facilitate responsive network support
After we finalize your enrollment into our network, you’ll also get access to Provider Direct, the online provider portal where you can manage claims, see member information, and more.

To best serve all current and potential members, we require priority admission for all women who are pregnant and injecting drugs, women who are pregnant and using substances, and for other individuals who are injecting drugs.

If you’re eager to help people with complex IDD/MH/SUD needs, review the information below to apply to join our closed network of providers.

Types of providers

Our provider network is a passionate group of professionals. Experts in diverse areas of care, they work with us to create a support system for our members and their families. Providers in our network falls into one of these groups:

Agencies offer one or more IDD/MH/SUD clinical or enhanced services. Examples:

  • Licensed Alternative Family-Living providers (AFLs)
  • Licensed facilities (i.e. Therapeutic Foster Care)
  • Community based services
  • Day program agencies
Hospitals are facility-based providers that provide inpatient, outpatient, and/or emergency services. They are licensed by the Department of Health Service Regulation and accredited by the Joint Commission.

Licensed Independent Practitioners (LIPs) are both solo providers and groups. Examples include but are not limited to:
  • Advanced Practice Psychiatric Clinical Nurse Specialists (PMHCNS-BC)
  • Board-Certified Behavior Analysts (BCBA)
  • Licensed Clinical Addiction Specialists (LCAS)
  • Licensed Physician Assistants (PA)
  • Licensed Clinician Mental Health Counselors (LCMHC)
  • Licensed Psychological Associates (LPA-Master’s Level Psychologists)
  • Master’s Level Social Workers (LCSW)
  • Medical Doctors (MD)
  • Practicing Psychologists (PhD and PsyD)
  • Psychiatric Nurse Practitioners (PMHNP-BC)
Our contracted providers deliver care to our North Carolina members who reside in Alamance, Cabarrus, Caswell, Chatham, Davidson, Davie, Forsyth, Franklin, Granville, Halifax, Mecklenburg, Orange, Rockingham, Person, Rowan, Stanly, Stokes, Union, Vance and Warren counties. 

For more information, please refer to our provider manual.

Service needs

We accept provider applications based on the services our members need. We find areas of need through capacity studies and regional research. Our published Service Needs List does not guarantee an offer to contract with new providers, or to add new sites or services to existing provider contracts.

Where am I needed? View the Service Needs List.

Applications

Ready to apply to join our newtwork of providers? Review the options below to find the application best for you. Please note, in order to be reimbursed for services rendered to Cardinal Innovations members, providers must:

  • Apply
  • Be credentialed by Cardinal Innovations
  • Be enrolled in NC Tracks

Once credentialed, providers are required to have their credentials reviewed, verified, and reapproved at a minimum of every 36 months from the date of the last credentialing review.

Licensed Independent Practitioner (LIP)/LIP Group Request for Contract Application

Licensed Independent Practitioners are both solo practitioners and practitioner groups. Review the Services Needs List to see what services your Solo LIP/LIP Group Practice can apply for.

If applying for SCS services, please see qualification requirements.

  • Advanced Practice Psychiatric Clinical Nurse Specialists (PMHCNS-BC)
  • Board-Certified Behavior Analysts (BCBA)
  • Licensed Clinical Addiction Specialists (LCAS)
  • Licensed Physician Assistants (PA)
  • Licensed Clinician Mental Health Counselors (LCMHC)
  • Licensed Psychological Associates (LPA-Master’s Level Psychologists)
  • Master’s Level Social Workers (LCSW)
  • Medical Doctors (MD)
  • Practicing Psychologists (PhD and PsyD)
  • Psychiatric Nurse Practitioners (PMHNP-BC)

LIP/LIP Group request for a contract

Agency application

If your agency can provide services such as IDD/MH/SUD clinical or enhanced services, use this agency application.

If you’re applying for outpatient services only, please refer to the LIP/LIP Group application above.

  • Licensed Alternative Family-Living providers (AFLs)
  • Licensed facilities (i.e. Therapeutic Foster Care)
  • Community-based services
  • Day-program agencies

Agency application

Hospital application

If you represent a hospital and wish to contract as a network provider, apply with our hospital application.

View hospital application.

Non-contracted hospital or physician group application

Apply with the physician group application if you represent a:

  • Physician or physician group and do not wish to contract as a network provider, but I seek payment for services
  • Hospital, and do not wish to contract as a network provider, but I seek payment for inpatient/ED services.

Physician group application.

Rendering practitioner for an existing contracted provider

The rendering practitioner credentialing form is for a rendering practioner who wishes to join our provider network.

Rendering practitioner credentialing registration form

In addition to the above selections, use the following to apply for specialty privileges to render the applicable service.

Individual Practitioner Application for Privileging to Render Sexual Harm Assessment Services for Children and Adolescents

Individual Practitioner Application for Privileging to Render Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) and Parent-Child Interaction Therapy (PCIT)

Member Specific Agreement (MSA)

In order to contract with Cardinal Innovations on a member-specific basis, a provider:

  • Must not currently have a Procurement Contract with Cardinal Innovations
  • Must be located outside of our 20-county catchment area
  • Must not serve more than two of our members

View more information on Member Specific Agreements.

NC Tracks

NC Tracks is the multi-payer Medicaid Management Information System used by the N.C. Department of Health and Human Services (NC DHHS). All contracted and out-of-network providers must enroll with NC Tracks to receive payment.

Home and Community Based Services

Providers who have services that fall under the purview of the Home and Community Based Services (HCBS) rule must meet that rule’s requirement for full integration so they can contract for those services.

More information about HCBS can be found in the resource library.

Credentialing & enrollment

We enroll providers into our network who provide a high quality of care and use safe, ethical, and responsible best practices to achieve positive clinical outcomes for our members. Our providers must plan services and supports with the individual's unique needs, culture, and environment in mind. We monitor the quality of care provided to our members on an ongoing basis.

Enrollment information for agencies, hospitals, and Licensed Independent Practitioners (LIPs) can be found in our Resource library.

After going through the application and credentialing process and being selected to join our network of providers a provider Procurement Contract is developed to complete the enrollment process.

More information can be found in the Resource library or on our page about working with us.

Additional information

Getting set up
Provider Direct is your online resource to make sure members get the appropriate care. Getting set up with the Provider Direct portal includes reviewing the tasks required to obtain a login and then completing a quick form to assign a System Administrator.

Our Trading Partner Agreement can be reviewed and signed online.

InfoSource
InfoSource is our email newsletter sent to our provider network. Don’t miss the latest information about important matters, including contracting and service requirements, events, and announcements by registering your email address.

Communication bulletins
Find the latest announcements for providers from InfoSource. Explore updates for our provider network about utilization management, network management, quality management, finance, and more.

Contact information
To speak with a member of our team, call our Provider Line at 1-855-270-3327 or email NetworkMgt@cardinalinnovations.org.

We take concerns and complaints seriously. You can express your concerns about Cardinal Innovations or report suspected fraud and abuse.

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