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CoastalCare manages a closed provider network for both Medicaid and State Funds. Any additional contracts or services to either of CoastalCare's Provider Networks are based on the results of continuous sufficiency monitoring. When network needs are identified they are posted at the link below. Please click here to view the identified service needs by county for the Medicaid Network. If you would like to apply to be credentialed by CoastalCare to deliver services listed on the needs table please select the link below appropriate for your type of business. Please Note: Applications submitted for services that are not on the needs list or not for the identified area will not be processed. For Licensed Independent Practioners (LIP) that are not currently credentialed through CoastalCare:
For Agencies that are not currently contracted with CoastalCare: For Agencies that are currently contracted with CoastalCare: For Hospitals please contact the Credentialing Department at credentialing@coastalcarenc.org or 910-459-4851 If you have questions regarding the credentialing process, please email credentialing@coastalcarenc.org If you have questions reqarding network needs, please contact Damon.Wells@coastalcarenc.org 910-459-4850 or Jennifer.Clapton@coastalcarenc.org 910-550-2649 Back to Top CoastalCare follows its’ Contract Selection Criteria Procedure for the contract selection process. In general, contract selection occurs simultaneously with the agency’s annual budgeting process. However, at any point during the fiscal year CoastalCare’s Management Team may identify a service need within the catchment area. When such a need is identified, a Request for Proposal (RFP) will be issued to the provider community. Outside of the yearly contract selection process, a provider who wishes to alter their current contract may do so by submitting a written request to Network Management. The request will be reviewed by CoastalCare’s Management Team and the provider will receive written notification of the results.
To Provide Medicaid Funded Basic Benefit Services to Children Outpatient Behavioral Health Services include assessment, treatment (individual and group therapy, behavioral health counseling) family therapy, and psychological testing. According to the Division of Medical Assistance, Clinical Coverage Policy 8C, section 5.2.1, licensed providers of outpatient behavioral health services (for Medicaid consumers under 21 years old) are required to obtain a referral from a Carolina Access primary care provider, the local management entity or a Medicaid enrolled psychiatrist.
DMA Clinical Coverage Policy 8C can be found at this link:
http://www.ncdhhs.gov/dma/mp/8C.pdf To be eligible for a referral number from CoastalCare, a provider must submit the following documents to the Network Management Department. (Directions) • Individual Performing Provider Profile
• Proof of Medicaid enrollment, licensure and Professional Liability insurance
• One signed original CoastalCare Memorandum of Agreement (MOA)
An applicant for licensure of a residential facility is required to obtain a letter of support from CoastalCare, in order to apply for licensure in the catchment area. Providers must request the letter of support in writing to CoastalCare's Network Management Department. The request for a letter of support must contain the elements identified in10A NCAC 27G .0406 which can be found within the core rules at this link:
http://www.ncdhhs.gov/mhddsas/statspublications/Manuals/apsm30-1_11-11.pdf http://www.ncdhhs.gov/mhddsas/providers/providerendorsement/archive/IU26/corerulessuggestions4-2.pdf
Information regarding licensure is located on The Division of Health Service Regulation’s website: |