New! Mecklenburg Community Operations Center Resource Guide >
Welcome to the Cardinal Innovations network of providers! Your assigned Network Specialist is indicated below. They will respond to any inquiries that you might have.
Mecklenburg COC Network Manager: Sharisse Johnson
|Provider/Agency Name Alpha Split:||Network Specialist Assignment:||Telephone:|
A - E
|F – I|
(Carolinas Healthcare System and The Arc of NC)
|J – 0|
(Innervision and Sunpath, LLC)
Amanda (“Mandy”) Canzonieri
|Q – Z|
|Joseph Coleman||(980) 938-4234|
Provider FAQs - Mecklenburg Transition >
Update - State and County funding for Mecklenburg behavioral health services >
Notice - Providers who:
1. have received a fully executed contract, signed by Cardinal Innovation Healthcare Solutions
2. completed the online Trading Partner Agreement(TPA)
3. completed the System Administrator Designee Form(s)
4. attended the System Administrator Training, and
5. have received their logins
can begin submitting Treatment Authorization Requests (TARS) for Medicaid services beginning on or after April 1, 2014.
As a reminder, MeckLINK will be transferring all existing authorizations for mental health and intellectual and developmental disability services that are effective beyond April 1, to Cardinal Innovations. We anticipate authorizations will be uploaded and available for review in Provider Direct the week of April 1, 2014. Notification will be provided via the website when the authorization data has been loaded so that providers can review their authorizations to ensure that all authorizations are in the Provider Direct System. Please note, that providers must submit TARS for substance abuse services, regardless of whether the provider has an existing authorization with MeckLINK, as those authorizations were not provided by MeckLINK.
It is not necessary to request any authorization that providers anticipate transitioning at this time. Providers will have through April 21 to submit TARS as needed for services beginning on April 1.
On Tuesday, February 4, 2014, the Mecklenburg Board of County Commissioners approved the transition of Mecklenburg County’s Medicaid Behavioral Healthcare services to Cardinal Innovations Healthcare Solutions. Cardinal Innovations will begin managing the 1915 (b)(c) waiver for Mecklenburg County consumers on April 1, 2014. For more detailed information, read the MeckLINK 2/5/2014 Provider HotSheet >
We will provide updates as this process moves forward. We welcome your questions but may not have all the answers right now. Questions may be submitted to firstname.lastname@example.org.
Mecklenburg Providers New to Cardinal Innovations
Cardinal Innovations has mailed or emailed new contracts to those providers in good standing that are currently contracted with MeckLINK. The sites and services listed in these contracts will be based on information provided to Cardinal Innovations by MeckLINK. The contract process is.
- Providers are receiving the Provider Contract by mail or email. The contract must be reviewed, signed and returned by the person who has the authority to sign contracts for the Agency/Practice. The cover letter explains what needs to be signed and witnessed, and what must be returned with the contract to Cardinal Innovations.
- As Cardinal Innovations receives signed contracts, they will be signed by our CEO and copies of the fully executed contracts will be emailed to providers.
- Please return the signed contract and attachments to Cardinal Innovations as soon as possible, but no later than March 10, 2014. This will help facilitate a smooth transition of authorizations and services on April 1.
Mecklenburg Providers Currently Contracted with Cardinal Innovations
Cardinal Innovations has mailed or emailed contract amendments to its current providers who are in good standing with MeckLINK and Cardinal Innovations. The sites and services listed in the amendment, referred to as Amendment M, are based on information provided to Cardinal Innovations by MeckLINK and only reference the added Mecklenburg sites and services.
In preparing for the addition of the Mecklenburg sites and services belonging to our existing Providers, Cardinal Innovations Healthcare Solutions learned that some of those Providers are contracted with MeckLINK under different Provider names and/or with different Provider Tax ID numbers. However, if you have not given Cardinal Innovations documentation to reflect a legal name change or a valid change in your Tax ID number with the IRS, Cardinal Innovations will not be able to list your MeckLINK Provider name or Tax ID for your Mecklenburg sites and services. If you are an existing Cardinal Innovations Provider, after April 1, 2014, you must submit all of your claims to Cardinal Innovations, including the ones for your Mecklenburg services, under the Provider name and Tax ID number that you currently have on record with Cardinal.
If you have changed your Provider name or Tax ID number, or the information that currently is on record with Cardinal Innovations is incorrect, please send a copy of your registration with the Secretary of State reflecting your correct name, or send the IRS letter reflecting your correct Tax ID number to us by e-mail at: email@example.com. We will use your documentation to update our records. Once we confirm that update, you will be free to use your corrected name and/or Tax ID number for all of your claims with us.
Thank you for your cooperation.
Provider Direct Login, Trading Partner Agreement and Processing Electronic Authorizations
Once a provider has a fully executed Provider Contract, the provider must perform the following steps in order to submit electronic Treatment Authorization Requests (TARs) and Claims:
- Secure a log-in for Cardinal Innovations' Provider Direct system, as well as designate a Provider Direct Systems Administrator
- Sign a Trading Partner Agreement (TPA). A TPA must be signed before Cardinal Innovations can accept electronic submissions.
Providers will find the instructions on how to get a Provider Direct log-in, as well as the forms to establish a Systems Administrator and TPA at Provider Direct Systems Administrator Designee Form and Instruction for Provider Direct Enrollment, with TPA >
Provider Questions Regarding Contracts
If there is a discrepancy identified upon receipt of your initial contract or amendment, please email: firstname.lastname@example.org.
Cardinal Innovations will respond with a brief form that the provider can use to identify the specific discrepancy, which will then be researched. Verified errors will be corrected as quickly as possible.
The effective date for the Mecklenburg contracts and amendments is April 1, 2014. Cardinal Innovations cannot reimburse any Mecklenburg claims with a date of service that precedes this effective date.
Contracts will be for Medicaid services only. Decisions regarding payments for state-funded services are under discussion with MeckLINK, Cardinal Innovations and DMH.
To the extent that a provider currently contracted with MeckLINK has services in its contract that are not offered by Cardinal Innovations, wherever possible, those services will be “cross-walked” to a comparable service in the Cardinal Innovations Service Array. Download crosswalk document >
Services will be reimbursed at Cardinal Innovations’ established Medicaid rates. Those rates can be viewed at Cardinal Innovations FY 2013-14 Rate Table >
Credentialing of Clinicians
A delegated credentialing agreement between Cardinal Innovations and MeckLINK will allow Cardinal Innovations to rely upon the credentialing completed by MeckLINK. This means contracted Mecklenburg providers will not need to resubmit credentialing materials for its associated clinicians who have already been credentialed. Clinician-based services may only be reimbursed by Cardinal for dates of service on or after April 1, 2014.
Clinicians who have not already been credentialed by MeckLINK will need to be credentialed by Cardinal Innovations. Additionally, clinician-based services cannot be paid for dates of service that precede the rendering clinician’s credentialing date.
IMPORTANT: Cardinal utilizes the Council for Affordable Quality Healthcare (CAQH) to obtain documents needed for credentialing and recredentialing. This serves as our application process for credentialing activities. Accordingly, all clinicians associated with currently contracted Mecklenburg providers are encouraged to submit an “Initial Registration Form” to Cardinal Innovations as soon as possible. An explanation of that process and necessary forms are located on the provider website. You can access these forms at Credentialing Instructions and Materials >
Cardinal Innovations has scheduled several communication forums for consumers, providers and stakeholders:
The provider webpage has a lot of resources to assist providers. Additionally, Cardinal Innovations plans to post PowerPoint trainings as an additional resource.
- The Provider Manual is a primary resource for providers. Access the current Provider Manuals >
- The following links will provide important and immediate information for providers. Please visit the provider webpage frequently for future updates and resources.
MeckLINK 2/5/2014 Provider HotSheet >
MeckLINK Provider Hot Sheets and notices page >
Cardinal Innovations Providers page >
The Cardinal Innovations team eagerly looks forward to working with Mecklenburg providers to ensure their continued provision of effective services to Mecklenburg consumers. Together, we will continue Cardinal Innovations’ commitment to being quality driven, solution focused and member inspired!
MECKLENBURG COMMUNITY OPERATIONS CENTER
(Covers Mecklenburg county)