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.
Applications
We are consolidating with Vaya Health in early 2022 and some of our counties are also realigning with other LME/MCOs. Information related to provider enrollment/credentialing can be found on each MCOs website.
Visit our County Realignment page for more information.
Hospital application
If you represent a hospital and wish to contract as a network provider, apply with our hospital application.
View hospital application.
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.
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.