Copy of Carolina Complete Health Provider Training Attestation

New Provider Orientation, Cultural Competency, EPSDT, and Compliance annual trainings.

To view all of our training and education, please visit our website

Question Title

* 1. Please indicate your practice-type:

Primary Care

Specialist

Ancillary

Hospital

Health Department

Question Title

* 2. Group Name

Question Title

* 3. TIN(s) for the practice/agency

Question Title

* 4. Your name (First, Last)

Question Title

* 5. Title/Role

Question Title

* 6. Email

Question Title

* 7. Attestation of attendance

By checking this box, I attest that I, or a member of the practice staff, have completed the Carolina Complete Health New Provider Orientation, Cultural Competency, EPSDT, and Compliance annual trainings

Question Title

* 8. Date you completed trainings

Date / Time

Date

Question Title

* 9. Please provide feedback on how we can improve your training experience

Question Title

* 10. From the following list of training topics, please select all those which you would likely attend if offered.

Provider Portal

Appeals Process

Complex Care

Cultural Competency/Health Equity

Filing a Claim

Integrated Care

Resiliency and Trauma-Informed Care

Value-Added Services

Unmet Health Related Resource Needs to include: housing, transportation, food access, interpersonal violence/toxic stress

Tailored Plans, Standard Plans, and Medicaid Managed Care