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Transition of Care

We know change can be scary. Carolina Complete Health wants to make this change easy. Whether you are new to North Carolina Medicaid Managed Care or are changing health plans, we will work to help you continue to get the services you need.

When you become a member of Carolina Complete Health, it is important to let us know right away if you were previously getting services that you will need to continue, so that we can provide you with the information that you need to make sure that happens. In some situations, this may involve assisting you in transitioning to a new provider. Other times we may be able to work with your previous provider to bring them into the network.  Either way, we can provide you with the information you need on how to switch health plans and continue receiving the services you need.

In most situations, we will honor an authorization for services issued by a different Medicaid plan in the state for 90 days. After that time, we may require additional authorization for the services. We will let you stay with an out-of-network provider for up to 90 days. In some cases, you may be able to keep your out-of-network provider for a longer period, as reviewed on a case-by-case basis. We will help you find a provider in our network that can provide the services you need. Our case managers can help get your medical records transferred to your new provider. Call Member Services at 1-833-552-3876 (TTY: 711), if you have questions about transitioning your care.