Trillium works with practitioners and distribution agencies to strengthen the well-being of the community by providing person-centred services and supports. To do this, Trillium and the supplier enter into a contractual agreement on the provision of services. Among the two main types of contractual agreements are: the purchase contract and the case-by-case agreement outside the network. An out of Network Single Case agreement, also known as SCA, is an agreement between Trillium and an unrelated network provider that wishes to provide services to a member. Single Case Agreements are member-specific, limited to a maximum of 5 members, and must obtain permission from Trillium outside the network before they can serve additional members. Before requesting an SCA with Trillium, a provider must confirm that there are no network providers capable of providing the service. To confirm, providers should do the following: If you have any questions about the form or process of requesting out of Network, you can email Trillium at OON@TrilliumNC.org. For best results, please save the Adobe PDF form to a local disk on your computer before filling out the form. Once the medical need has been identified, the provider must submit a completed Single Network Agreement Request Form, along with the forms and support documents necessary for the contracted service. Missing and inaccurate information leads to delays in this process. *Network providers (with full contracts) should not use the out of Network request process or send the out of Network Request form. Network providers should contact Network Development via email at NetworkServicesSupport@TrilliumNC.org if a service need is identified for a given member.
The purchase agreement is awarded to practitioners and agencies who have completed the Trillium registration process and are considered qualified to participate in Trillium`s supplier network. The purchase contract is for a maximum period of three years and is the preferred market method. NC Tracks is the national multi-payer Medicaid Management information system used by the N.C. Department of Health and Human Services (NC DHHS). All providers that provide services to members must register with NC Tracks. In addition, all suppliers must have appropriate licenses, accreditations and registrations for their establishments and employees, while providing services to Trillium members. The OON application form and supporting documents can be submitted to the contractual division 1 of 3 Options: Please at the time of application, please make available: If no network provider is available, the out-of-network access provider must contact Trillium Utilization Management before sending the request in order to determine the medical necessity. The purchase agreement has been revised and will enter into force on 1 November 2020. Fully related practitioners and providers who have a contract that expires on or after November 1, 2020 will receive the revised contract when their current contract expires. Usage management can be contacted from 1 of 3:. . .