Provider

Our goal at Eastpointe is to offer the highest quality provider network services for our members. We realize we play an important role in supporting our providers by making information and resources easily accessible. If you have any questions or need additional information, please contact network operations Monday – Friday, 8:30-4:30 at 1-888-977-2160, or email networkoperations@eastpointe.net.

Behavioral Health Screening Program

We ensure those seeking help are linked to treatment to meet their needs. Our goal is to show co-existing disorders and assess suicide risk by offering screenings. Screenings are tools used to identify areas of concern by asking questions. Co-existing means having a substance use and mental health disorder at the same time. Knowing the areas of concern early, helps to make sure correct treatment is given and screenings are usually brief. Evidence suggests identifying those at risk of suicide and continued treatment along with support, produce positive outcomes.

The Centers for Disease Control and Prevention (CDC), reports in 2017 suicide was the 10th leading cause of death in the US, claiming the lives of over 47,000. It was the 2nd for ages of 10-34, and 4th for 35-54. In NC, it was the 11th leading cause of death with more than 1,400 dying. It is 2nd for ages 15-34, 3rd for 10-14 with an estimated 1,400,000 attempts in the US per the American Foundation for Suicide Prevention. On average, 1 person dies by suicide every 6 hours.

Contracting and Payment for Services

Eastpointe forms and information for contracting and submitting claims and payments.

Information, Manuals, and Forms

A comprehensive hub for all information, forms and manuals (block grants, general laws, rules and regulations, innovations, provider operations manual, sex offender treatment and system of care).

Program Integrity

Eastpointe’s Program Integrity Department is responsible for investigating concerns/complaints that pertain to allegations of provider fraud, waste and abuse for both Medicaid and State programs.

Meetings and Trainings

Keep up to date with our provider meetings and trainings on important topics such as government programs, service updates, quality assurance and monitoring and more. Meetings and trainings are recorded and organized by category for easy accessibility.

Becoming a Provider

Eastpointe is a closed network; however, we are currently accepting hospitals and Licensed Independent Practitioners . Service additions are determined by network needs and available resources. For more information, please call Network Operations, 1-888-977-2160.

Provider Council

The Eastpointe Network Provider Council represents our provider network and advises on quality-of-care concerns, funding, integrated services and more. This section includes the council’s mission and code of ethics statement and complete member roster /contact information.

Authorization (UM) and Benefits Packages

Our treatment practices and clinical care guidelines for Eastpointe members.

Quality Management

Our Quality Management Program uses a systematic approach to monitor and evaluate care access, appropriateness, safety and effectiveness so that we can continually improve our system of care. This section includes reports and plans related to the Quality Improvement Program and minutes from our Global Quality Improvement Committee.

Residential Vacancy

Tool/resource used by Providers, Eastpointe Care Coordinators/staff to list/view immediate and pending availability of licensed residential beds offered by In-network Providers and/or non contracted providers who may have a vacancy within the Eastpointe 10 county catchment area when members need referrals for placement.

NC HealthConnex

NC HealthConnex is North Carolina’s new, modernized health information exchange, which delivers added value to the conversations that are happening at all levels in the healthcare industry. It breaks down information silos between providers, achieves greater outcomes for patients and creates efficiencies in state-funded programs such as Medicaid.