Effective August 1, 2024, Carolina Complete Health will institute high dollar pre-payment review requirements for hospital inpatient claims with a header or total billed amount greater than $250k.


Beginning August 1, 2024, any hospital inpatient claim billed to Carolina Complete Health greater than $250k will be subject to a pre-payment review.

What to expect:

  • Proactive submission of itemized bill: For any hospital inpatient claim greater than $250k, please include an itemized bill along with the claim submission.
  • If an itemized bill is not included with the original claim, it will cause delay and/or partial payment.

If you have questions, please contact your Provider Engagement Administrator. If you need your Provider Engagement Administrator’s contact information, please email [email protected]