The monthly Provider Insider Newsletter differs from the Network Communication Bulletins by offering an avenue to highlight community happenings across our catchment area. We will share information on various projects Trillium is working on within our local communities and introduce new skill development/training opportunities available to providers. | |
- Provider News
- Proposed Medicaid Policies
- Community Involvement
- Provider Resources
- New Opportunities
- Provider Knowledge
- In Case You Missed It
| | ATTENTION: TRILLIUM TAILORED PLAN BEHAVIORAL AND PHYSICAL HEALTH PROVIDERS | | |
Due to an unexpected processing delay associated with our new claims payment system, providers may notice that their scheduled payments were not deposited as early as usual on October 22, 2026. Payments should have been deposited into provider bank accounts on October 22. 2026.
We apologize for the inconvenience and appreciate your patience as we complete this transition.
Errors and Issues:
Claims Submission NPI Error
If you receive the error message, “The rendering/attending provider taxonomy is not associated with the attending/rending provider NPI on this claim,” you may be trying to submit a claim through the wrong entity. Providers billing a clinician-based service should use the NPI of the rendering provider and not the NPI of the agency.
Known Issues Tracker
Questions about other system errors? We will continue updating the Known Issues Tracker on our website accordingly, so we encourage you to check that ahead of submitting a new ticket to check if Trillium is already addressing the issue.
Accessing Support
Unsure of your onboarding status, struggling with access to iTransact, or have issues with SFTP setup? Contact us.
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Missing our phone calls?
Trillium numbers can sometimes be identified as “Potential Spam,” “No Caller ID,” or “Block” from 888-735-9151. Please check with your carrier or IT department to ensure that return calls are not being blocked.
Action Required: Submit Financial Forms
If your organization is a physical health provider that began participating in Trillium's network through CCH and has not completed a separate contracting process directly with Trillium, you must submit the required financial forms directly to Trillium as soon as possible. Submit your forms here: Trillium Provider Setup Form
Why is this Required?
When your organization joined Trillium's network through its existing agreement with CCH, your financial documentation was not provided to Trillium, including required documents such as the W-9 form. Trillium needs this information to complete your provider financial setup and process payments.
Important: Impact on Payments
To avoid payment delays, please complete this requirement by 11/6/2026.
Who Does Not Need to Take Action?
Tailored Plan Behavioral Health Providers do not need to submit financial forms. These providers are already contracted with Trillium, and no additional financial documentation is required at this time.
Questions or Need Assistance?
If you are unsure whether this requirement applies to your organization or need help completing the forms, Trillium's Vendor Team is available to assist. Please email for assistance.
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Authorization Tips:
Specialty Services
Trillium has implemented Flexibilities beginning October 1, 2026 through January 4, 2027. During this period, no prior authorization is required for outpatient specialized services, including:
- Physical Therapy
- Occupational Therapy
- Speech Therapy
- Audiology Therapy
Authorization Attachment File Size Limit
The iTransact portal has a 12 mb file size for attachments. If you see this message when trying to attach a file, it is too big. Please decrease the size of the file by removing pages, zipping the file, or breaking the file into pieces in order to attach the necessary information.
Claims Denials and Pending Claims: Provider Hardship Payments
The Provider Hardship Form is used to request consideration for a hardship payment advance when a provider is experiencing a significant, temporary reduction in BH I/DD Tailored Plan claims payments due to circumstances beyond the provider's control. For more information and to request a hardship payment, see the Billing and Claims page on our website.
Website Updates
As a reminder, new guidance and documents are on pages below. Please update any bookmarks or saved documents:
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All Trillium Tailored Plan Behavioral and Physical Health providers are encouraged to visit the Tailored Plan Claims Platform Migration webpage for resources, including but not limited to:
- Onboarding instructions for Tailored Plan Behavioral Health and Physical Health providers on the new unified claims platform
- Presentations and recordings from past information sessions (Information Sessions and Communications tile)
- New instructions for submitting Tailored Plan authorizations (Authorizations tile)
- Tailored Plan special announcements, including additional guidance on the provider claims system (Information Sessions and Communications tile)
- Instructions for submitting EFT forms to Trillium, including W-9s for Tailored Plan providers who have not yet submitted them (Finance tile)
- Unified Claims System: Frequently Asked Questions (FAQs), last updated October 21, 2026
Important Contact Information
| | Innovations Direct Care Workers Rate Increase | | |
Medicaid recently announced that the incremental Innovations Waiver Direct Care Worker (DCW) rate increases are effective October 1, 2026, and are retroactive to July 1, 2026. The initiative is supported by $21.3 million in recurring state funds appropriated under Session Law 2026-41, Section 9E.14.
The rate increase is intended to benefit eligible Innovations Waiver direct care workers. Providers may use the increased funding to support eligible DCWs through:
- Increased hourly wages;
- Employee benefits; and/or
- Associated payroll costs.
Innovations Waiver DCW Add-Ons
Implementation and Claims Reprocessing
Trillium has released an updated fee schedule containing the Innovations DCW increases retroactive to July 1, 2026. Providers can begin using the updated rates on or after October 5, 2026. If you have questions regarding the Innovations Waiver DCW rate increases, please contact the Rates Team at RatesFinance@TrilliumNC.org.
Trillium will also reprocess claims with dates of service on or after July 1, 2026, to ensure that providers receive the increased rates retroactive to that date. Innovations claims that have already been processed and are impacted by the rate increase will be reprocessed by Trillium back to July 1, 2026. No action is required by providers at this time.
Additional Requirements
Please be aware that additional requirements apply to providers receiving the DCW rate increase. These requirements include:
- Completion and submission of a signed attestation;
- Annual reporting; and
- Maintenance of appropriate supporting documentation, including payroll and other records demonstrating how the increased funds are being utilized.
Additional communication regarding these requirements will be provided in the future.
Additional Information
For more information, please refer to:
| | Mandatory Closed Network for Peer Support and Research-Based Behavioral Health Treatment (RB-BHT) Services | | |
We want to let you know about an important update affecting North Carolina Medicaid behavioral health services. Effective July 2, 2026, North Carolina Senate Bill 257 (the Current Operations Appropriations Act of 2026) requires each Prepaid Health Plan (PHP) to establish a mandatory closed network for the two service categories below, with the authority to determine which providers participate:
- Peer Support Services
- Research-Based Behavioral Health Treatment (RB-BHT) Services
In line with this requirement, Trillium will be maintaining a closed network for both services. We appreciate the work you do for the individuals and families we serve.
| | Proposed Medicaid Policies | | |
The North Carolina Department of Health and Human Services (NCDHHS), through its Division of Health Benefits (NC Medicaid), regularly publishes new and updated Clinical Coverage Policies for public review. We encourage providers to check out the policies currently open for public comment.
View Medicaid Policies Open For Comment
| | Trillium Unified Claims System | | |
Effective October 1, 2026, Trillium transitioned to a unified claims system for Tailored Plan operations only called iTransact. All Tailored Plan Contracted providers of behavioral health, physical health, and long-term services and supports (LTSS) will submit claims through a single portal.
This adjustment does not affect providers who hold an NC Medicaid Direct or State-funded only contract with Trillium.
Prior to October 1, 2026, physical health and LTSS providers who deliver services to Trillium Tailored Plan members submitted claims to Carolina Complete Health for payment.
Beginning October 1, 2026, all claims for these services must be submitted to Trillium. This transition will enhance administrative efficiency, transparency, and accountability in claims processing and payment. At this time, the primary change for providers is the way claims will be submitted. This transition will enhance administrative efficiency, transparency, and accountability in claims processing and payment. At this time, the primary change for providers is the way claims will be submitted.
Additional Claims System Resources
| | The Technology Ultimate Living Assistant (TULA) Pathway to Ongoing Remote Support and Independence | | |
Join Inclusion Connects for an engaging overview of how the Technology Ultimate Living Assistant (TULA) program supports members from the first referral through long-term remote support services. This webinar will explain the referral process, describe the assessment approach, and highlight how TULA collaborates with members, families, providers, and care teams to put technology supports in place that strengthen independence, safety, and quality of life.
Register Here
| | Trillium Help with Housing Needs | | |
A safe, stable home is an important part of health, independence, and well-being. But finding a place to live can be hard, especially for people with serious health conditions or who have limitations in working a full-time job.
A person with an intellectual or developmental disability may need a home that is affordable, accessible, and has the right supports nearby. Someone living with a mental health or substance use disorder may face challenges such as limited income, past evictions, or difficulty finding housing that meets their needs. Without stable housing, it can be harder to get to appointments, take medicine, get enough sleep, and stay connected to care.
Trillium helps our members to support their health, independent living, and recovery goals. While Trillium does not directly offer housing to members, we can get them in touch with resources and people who can help.
View Resources Here
| | Adolescent Perinatal Residential Program: New Opportunity for Providers | | |
Trillium Health Resources is looking for qualified nonprofit organizations to create and run a new residential treatment program for pregnant and parenting adolescent females who have substance use disorders. This program will fill an important gap in services for young people who need 24-hour support in a safe, structured setting.
The program will focus on the whole person. Support will include medical care, pregnancy and parenting help, infant and child development, education, family relationships, and learning the skills needed for independent living. Recovery support and planning for a successful return to the community are also key parts of the program.
This is an important opportunity to strengthen services for adolescents and their families. For more information or to apply, visit Trillium’s website. The deadline for the RFA submission is November 6, 2026.
| | Crisis Intervention Team (CIT) Training | | |
Crisis Intervention Team (CIT) training educates law enforcement officers about the signs of individuals with mental illness, substance use disorders, or intellectual/developmental disabilities (I/DD). Many people need treatment instead of going to jail.
Law enforcement and health officials say about 20 percent of police calls involve people having a mental health crisis. Trillium staff has helped train hundreds of law enforcement staff throughout our area, including police officers, county deputies, school resource officers, university campus police, detention center officers and telecommunications staff. Citizens who call police to respond to someone in crisis can specifically ask for a CIT-trained police officer.
If you have any questions or would like to discuss a training, read our CIT Brochure or call 1-866-998-2597 and ask for a CIT coordinator or email CIT@TrilliumNC.org.
Learn More Here
| | National Alliance on Mental Illness (NAMI) NC Annual Conference | | |
When people passionate about mental health come together with courage and commitment, there's no limit to what we can build.
The NAMI North Carolina Annual Conference brings together mental health advocates, peers, providers, and families to share perspectives, learn best practices, and discover new innovations in the world of mental health.
Guided by a theme of "Breaking Ground for a Brighter Future," this inspiring event will explore technological advances in mental healthcare, shared experiences and stories, and collaborative solutions as we break new ground in mental health advocacy and support. By working together, we build on the foundation of our mission - ensuring that individuals and families affected by mental illness can build better lives.
Held in Raleigh, our state's beautiful capital city, this year's conference features enlightening breakout sessions, exciting keynote presentations, a lively exhibition hall, continuing education credit for providers, and myriad networking opportunities with other mental health advocates.
Register and View Conference Details
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Trillium Unified Claims System Launched on October 1, 2026
Effective October 1, 2026, Trillium transitioned to a unified claims system for Tailored Plan operations only. All providers of behavioral health, physical health, and long-term services and supports (LTSS) will submit claims through a single portal.
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Gaps in Provider Choice
Trillium has identified network gaps in services across our region and is actively accepting applications for provider development. If your organization is interested in providing any of the services needed, please click on this link, fill out the form and submit.
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Have Questions/Need Support?
If you have questions, need additional information, or require technical assistance, please contact our Network Management Department at NetworkServicesSupport@TrilliumNC.org or call Provider Support Services at 1-855-250-1539 during the hours of 7 a.m.–6 p.m. EST, Monday–Saturday.
We appreciate your commitment to helping us achieve this mission by meeting the needs of members!
| | Provider Insider is a newsletter for the Trillium Health Resources provider community. Please send comments and suggestions about this publication and its contents to NetworkServicesSupport@TrilliumNC.org. | | | | |
