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Are you a former Cardinal Innovations Healthcare provider? Find documentation related to claims, rate tables, and more below. This documentation will remain available until Dec. 31, 2022.

Cardinal Innovations Provider Network Documentation

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Frequently asked questions

Information related to provider enrollment/credentialing can be found on each MCO’s website.

The new MCOs have indicated that they will honor all existing rates for providers. However, rates are at the sole discretion of the new LME/MCO. For more information, please visit their website.

For all services rendered prior to December 31, 2021, providers will submit claims exactly as they do today, via Provider Direct. All services rendered after December 31, 2021 should be submitted to Vaya (insert link) for reimbursement. Any claim submitted to Cardinal for services after December 31st will be denied as member not eligible. For more detail, click here (insert link to bulletin).

Your patients and clients’ new LME/MCO depends on their county of permanent residence. Refer to our LME/MCO transition map to find out which LME/MCO has acquired each county.

Although Cardinal Innovations counties have realigned to new LME/MCOs, North Carolina’s transition to Tailored Plans will continue in 2022. Look to your new LME/MCO in your county to provide guidance around Medicaid Transformation, Tailored Plans, and enrollment in 2022 or visit the NC Medicaid enrollment website.

Oustanding claims

Need to submit a claim for Cardinal Innovations?

Claims for services provided through Dec. 31, 2021 can be submitted and processed up until Dec. 31, 2022.