Billing and Claims
Trillium Health Resources provides extensive instructions to providers on submitting claims and necessary paperwork in our Provider Manual and online training once contracted with Trillium. Please review the manual and reference trainings for specific details.
Providers must have staff with access to our provider portals in order to submit claims. If your agency is new to Trillium and does not have a system administrator for the correct provider portal, someone at your agency should be designated as the system administrator for the correct portal (either for the Trillium Tailored Plan or NC Medicaid Direct). Please complete the System Administrator training on ProviderMyLearningCampus.org before receiving access to the portal.
All claims must be submitted within the timeframes outlined in your provider contract from the date of service, or in the case of a health care provider facility, within 365 days after the date if the member’s discharge for Medicaid-funded claims.
Below are the most commonly used forms and materials related to claims and billing.
Trillium webpages:
Trillium Forms
- 837I Institutional Health Care Claim
- 837P Professional Health Care Claim
- Authorization Agreement for Direct Deposit
- Claims Billing Guide
- Claims Request Form Instructions
- Claims Request Form
- Deficit Reduction Act Attestation
- Provider Hardship
- Known Issues Tracker
- Medicaid Direct & Tailored Plan Claims Submission Protocol
- National Correct Coding Initiative (NCCI) Fact sheet
- Request for Taxpayer - W9
- Prompt Payment Tip Sheet
- Remittance Advice (RA) Companion Guide
- Submission Address for Paper Claims (Out-of-State Providers)
- Replacement Voided Denied Claims Process
- Taxonomy Claim Submission Fact Sheet
- Tailored Care Management Billing Guide
- Tailored Plan Physical Health Claim Reconsideration and Grievance Form