Provider Service Application

Medicaid Service Needs

This recruitment is being used as a means to expand the network of qualified, approved NC Medicaid providers that are experienced to provide high quality services to Trillium Members. Please only apply for designated counties in the application.

Interested providers must submit an application to apply for consideration for the following service needs:


  • Partial Hospitalization
  • Opioid Treatment Program
  • Psychosocial Rehabilitation
  • Substance Abuse Comprehensive Outpatient Treatment (SACOT)
  • Substance Abuse Intensive Outpatient Program (SAIOP) for Youth


Important Information

> Provider MUST meet all qualifications of the service and NC Medicaid to be eligible for a contract award.

> Separate forms must be submitted for each service of interest.

> Recruitment is for Medicaid services only.

> No start-up funding available from Trillium. Provider must be fiscally sound and have capital to start programs independently.

> Application does not guarantee a contract. Providers are advised to wait until official contract award prior to implementing programs.

> Provider must be an approved NC Medicaid provider and enrolled in NC Tracks.

> More than one provider may be selected for a service if warranted based on member need.


This recruitment should not be interpreted as a contract (implicit, explicit, or implied), nor does it imply any form of an agreement to any potential candidate. In addition, no inference should be made that Trillium will purchase and/or implement in the future any of the programs or services proposed by the respondents.