Cardinal Innovations Healthcare is the country's largest specialty health plan, serving 875,000 individuals who are eligible for Medicaid or are uninsured with complex needs throughout North Carolina. Cardinal Innovations pioneered this unique managed care model in North Carolina, which relies on strong community partnerships with providers and stakeholders.
Cardinal Innovations operates at-risk capitated health plans for individuals with complex needs with a commitment to our members that they receive the healthcare services they need to live fuller lives. We maintain a community presence with offices in Charlotte, Chapel Hill, Kannapolis, Concord, Burlington and Henderson.
Cardinal Innovations promotes a personalized approach to healthcare to further empower individuals. Through person-centered planning philosophies that incorporate both social supports and healthcare services, we are able to better meet the individual needs of our members. The positive outcomes experienced by our members are a direct result of this integrated approach and the infrastructure that links individuals with complex needs to clinical and natural supports in their communities.
Evidence of Cardinal Innovations' clinical expertise begins the moment an individual is enrolled, making sure the best services are available, linking members to those services and monitoring service delivery to fulfill the individual's needs. Cardinal Innovations is fully accredited by the National Committee for Quality Assurance, a private, non-profit organization dedicated to improving healthcare quality.
At Cardinal Innovations, we create innovative solutions aimed at achieving quality health outcomes that include the improvement of symptoms, an enhanced quality of life, reduced use of higher levels of care and ultimately, a reduction on the total cost of care. Our network of providers shares our commitment to quality care, integrity and accountability. Through routine oversight and collaboration on clinical and quality initiatives, we ensure that our members receive care from high quality providers. Cardinal Innovations' robust provider network ensures individuals with complex needs receive the best-in-practice treatments and have opportunities to integrate into their communities.
Our community-based model of managed care is designed to encourage a natural interaction with members, local providers and stakeholders. Our trained professionals live and work in the communities we serve, which allows us to gain a unique perspective and fuller picture of our members and provider networks. Our local presence and high-touch philosophy are central to creating a positive experience for all who interact with Cardinal Innovations. We rely on the dedication of care coordinators who work directly with members and their families; community partners who provide education opportunities, and advocacy and outreach; and network and quality management specialists who partner with providers to achieve the best outcomes. Cardinal Innovations utilizes relationships with community stakeholders and healthcare providers to identify service gaps and resources to improve a community's overall health.
Our success in delivering innovative solutions is a direct result of our commitment to reinvest in our members and their communities. Every dollar we save is returned to the individuals and communities we serve to create new services, enhance provider delivery models, better align community resources or update operational efficiencies for our providers.
Business and Information Technology Services
Cardinal Innovations owns and operates a sophisticated, proprietary technical system for processing claims and maintaining health service and eligibility records that is specifically tailored to operate in a managed care environment. CI Enterprise was developed to establish a total business solution for managed care to optimize financial and information technology services. Our system offers unsurpassed state-of-the-art architecture, business systems and technical expertise, now used widely throughout North Carolina. CI Enterprise operates in 40 of North Carolina's 100 counties, and serves 35 percent of the state's Medicaid recipients.
The Cardinal Innovations Service Center relies on the scalable and highly integrated CI Enterprise platform to provide a fully integrated business solution for claims processing and eligibility determinations for managed care. Cardinal Innovations' Service Center processes and pays approximately $50 million in claims monthly and manages eligibility for over 360,000 Medicaid members accessing services.
As a result of the success of the Service Center, Cardinal Innovations routinely rates high in customer satisfaction, both related to the delivery of timely and accurate payments to providers and seamless service delivery to our members.
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550 S Caldwell St, Charlotte, NC 28202