How can I help my patient confirm eligibility?

Individuals with IDD/MH/SUD who receive Medicaid in our coverage areas are eligible. Our team confirms each person's health plan based on specific criteria. For more information, refer to the Members page.

How do I file a claim or a claim inquiry to receive payment?

Submit claims through Provider Direct or an 837 file, unless your contract states another method. We encourage you to produce routine billings on a weekly or bi-monthly basis. The Provider Direct Manual gives specific instructions on information needed to complete a claim form. The Provider Direct Manual is available on the portal.

How do I report a concern, fraud, or abuse?

You can report a concern via telephone, online, or by mail. Review examples of fraud and abuse. Online Complete our suspected fraud and abuse reporting form. Telephone Call our toll-free Fraud and Abuse Line to leave a confidential voicemail at 1-800-357-9084. Mail Cardinal Innovations Healthcare Attention: Program Integrity Unit 550 S. Caldwell St., Suite 1500 Charlotte, North Carolina 28203

Providers

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Provider Direct

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Provider Network

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