Network Management

​Network Management is committed to working closely with our providers to ensure they have what they need to better serve our members. We collaborate with providers to ensure the provision of high quality care for our members and timely reimbursement to our providers for the care provided.

Our commitment includes:

  • Identifying service gaps
  • Contracting with providers
  • Enrolling providers

Credentialing & Enrollment

Our Network Management Department is responsible for managing our providers. This includes:

  • Contracting with providers
  • Enrolling them in the Cardinal Innovations Provider Network
  • Maintaining and managing contracts
  • Amending contracts as necessary to reflect services delivered and the locations where members are served

Helping Connect Members with Providers

Network Management maintains a Provider Directory on our website to assist members when looking for a provider.

Provider Direct

Provider Direct, a part of the Cardinal Innovations (CI) Enterprise, offers a secure online application that allows electronic data communication between providers and Cardinal Innovations. CI Enterprise was developed by Cardinal Innovations to establish a total business solution for managed care to optimize financial and technology services. It is a web-based application accessible from any location at any time. Provider Direct allows providers to:

  • Submit claims electronically using form entry or file upload
  • Create and submit Treatment Authorization Requests (TARs)
  • Create and update member enrollment records
  • Update clinical documentation
  • Receive status updates on submitted requests
  • Receive on-line training for using Provider Direct

Each provider organization must have a system administrator who is responsible for creating and disabling user accounts for its providers. Contact your system administrator to get a Provider Direct login. If you do not have a system administrator, please visit the designee page. If you are unsure who your system administrator is, you can contact our helpdesk at 704.939.7773 and select Option #1.

Network Management provides training and other informative provider communications, and also updates the Provider Manual annually.