Partners Health Management Tailored Plan: Behavioral Health Billing
Partners Health Management runs the Tailored Plan across a group of western and Piedmont counties, and almost everything a behavioral health provider does with it runs through one portal. Knowing the exceptions, when that portal is down or when you are out of network, saves claims.
Short answer
Partners Health Management operates an NC Medicaid Behavioral Health and I/DD Tailored Plan. Authorization requests and claims go through the Partners ProviderCONNECT portal. A Manual Authorization Request Form is used when the authorization system is unavailable for four hours or more, or when an out-of-network provider is serving a Partners member who needs specialty treatment not available in the network.
Where Partners fits
Partners Health Management is one of North Carolina's Behavioral Health and I/DD Tailored Plans, which launched July 1, 2024 for members with significant behavioral health, substance use, I/DD, or TBI needs, and which manage the enhanced behavioral health services Standard Plans do not. Tailored Plans serve defined counties, so confirm both the member's plan and your contract with it.
Authorizations and claims
Partners reviews and processes authorization requests for Tailored Plan members through ProviderCONNECT, and claims are submitted through the same portal. Its service area includes Burke, Cabarrus, Catawba, Cleveland, Davie, Forsyth, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union, and Yadkin counties; confirm the current list with Partners.
The manual authorization fallback
Partners provides a Manual Authorization Request Form for two situations: when the authorization system is unavailable for an extended period, four hours or more, and when the provider is out of network or non-participating and is serving a Partners member who needs specialty treatment not available in the network.
Where behavioral health claims go wrong
- Out-of-network without the manual form. Specialty services delivered out of network without the required request.
- Member lives outside Partners' counties. Tailored Plan membership follows the member's county.
- Member is in a Standard Plan. Behavioral health billed to Partners for a member who is not in its Tailored Plan.
Related: verifying NC Medicaid eligibility in NCTracks, associate-level clinician billing in NC, and the NC Medicaid behavioral health billing guide.
Sources, checked October 2026: Partners Tailored Plan provider resources; Partners and Carolina Complete Health FAQ. Confirm current details on the plan's provider site.
Frequently asked questions
How do I submit claims to Partners Health Management?
Through the Partners ProviderCONNECT portal, which also handles authorization requests for Tailored Plan members.
When do I use Partners' Manual Authorization Request Form?
When the authorization system is unavailable for four hours or more, or when an out-of-network provider is serving a Partners member who needs specialty treatment not available in the network.
Which counties does Partners serve?
Its service area includes Burke, Cabarrus, Catawba, Cleveland, Davie, Forsyth, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union, and Yadkin counties. Confirm the current list with Partners.
Is Partners Health Management a Tailored Plan?
Yes. Partners operates a Behavioral Health and I/DD Tailored Plan for members with significant behavioral health, substance use, I/DD, or TBI needs.
Tailored Plan authorizations, tracked.
See Stable track Partners authorizations against services and catch gaps before the claim goes out.
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