Medicaid Members
WEโRE HIRING
Blu Roses Garden LLC is seeking certified Peer Support Specialists (PSS) and Personal Care Services (PCS) staff to work as 1099 independent contractors, contingent upon:
- Active Medicaid authorization
- Provider enrollment approval
- Service activation by the applicable managed care organization
All hiring is subject to compliance with NC Medicaid, managed care, and credentialing requirements.
๐ฟ Medicaid Members We Serve
Blu Roses Garden LLC is an In-Network Participating Provider with:
- Carolina Complete Health (CCH)
- Vaya Health
Medicaid services are provided only when medically necessary, prior authorized, and approved on the memberโs Care Plan, in accordance with NC Medicaid, managed care, and applicable LTSS/PSS policies.
๐ฟ Carolina Complete Health Members
Blu Roses Garden LLC is contracted as a Participating Provider with Carolina Complete Health under:
- Medicaid Standard Plan
- Medicaid Tailored Plan (when delegated)
Services may be provided through Carolina Complete Healthโs delegated arrangements with:
- Partners Health Management
- Trillium Health Resources
Eligible members may receive covered services only when authorized by their Care Manager and included on their approved Care Plan.
๐ฆ Vaya Health Members
(Medicaid Tailored Plan)
Blu Roses Garden LLC is also an In-Network Participating Provider with Vaya Health.
For members enrolled with Vaya Health:
- Blu Roses Garden LLC provides authorized Peer Support services
- Peer Support services are delivered only by a certified Peer Support Specialist (PSS)
- All Peer Support services are supervised by a Qualified Professional (QP) in accordance with NC Medicaid and Vaya Health policy
โก๏ธ Direct one-on-one Qualified Professional (QP) services are not available under Vaya Health or Carolina Complete Health at this time.
All Medicaid services must be:
- Authorized on the memberโs official Care Plan
- Coordinated through the assigned Care Manager
- Delivered in compliance with Vaya Health and NC Medicaid requirements
โญ Who Is Eligible?
You may be eligible to receive Medicaid-covered services through Blu Roses Garden LLC if you are enrolled in:
- Carolina Complete Health (Medicaid Standard Plan)
- Carolina Complete Health (Tailored Plan via Partners or Trillium)
- Vaya Health (Medicaid Tailored Plan)
All Medicaid services require active prior authorization on the memberโs Care Plan.
Eligibility and authorization must be confirmed through your assigned Care Manager or Member Services.
๐ฑ Covered Support Services (Medicaid)
For Medicaid members, Blu Roses Garden LLC provides services only as authorized on the approved Care Plan and only within the CPT/HCPCS codes approved for our agency by the applicable managed care organization.
Authorized services may include:
- LTSS planning and oversight functions performed by a Qualified Professional
- Care Plan implementation support
- Coordination with the memberโs interdisciplinary care team
All Medicaid services are delivered in full compliance with:
- NC Medicaid policy
- Carolina Complete Health or Vaya Health requirements
- Medical necessity criteria
- Prior authorization and documentation standards
๐ฟ Private-Pay Services
(When Medicaid Coverage Is Not Available)
If you do not have Medicaid, your plan does not authorize services, or you are awaiting approval, private-pay support options may be available.
Private-pay services:
- Are not billed to Medicaid
- Are offered separately from managed care services
- Are discussed in advance, including scope and pricing
๐ Contact us directly to inquire about current private-pay options and availability.
๐ How Members Get Started
For Medicaid-covered services, the process always begins with your Care Manager.
Steps to request Medicaid services:
- Contact your Care Manager (Carolina Complete, Partners, Trillium, or Vaya Health) or Member Services
- Request authorization for the LTSS or Peer Support service for which you are eligible
- Request Blu Roses Garden LLC as your preferred provider
Once authorization is approved, the Care Manager will submit a referral to our agency, and we will contact you to begin services.
For private-pay services, you may contact us directly.
๐งพ No Out-of-Pocket Costs
(Medicaid Services Only)
Authorized Medicaid services are covered based on:
- Active Medicaid eligibility
- Medical necessity
- Approved prior authorization
Blu Roses Garden LLC does not bill Medicaid members directly for covered services, in accordance with Medicaid Hold Harmless provisions.
๐ผ Our Commitment
Blu Roses Garden LLC is committed to providing respectful, person-centered support while maintaining strict compliance with all Medicaid and managed care requirements.
We uphold:
- Non-discrimination standards
- Trauma-informed service principles
- Coordination with the full care team
- Ethical, compliant, and accountable service delivery
โ ๏ธ Important Notice
Medicaid-covered services are limited to those authorized by Carolina Complete Health or Vaya Health and documented on the memberโs approved Care Plan.
Private-pay services are offered separately and are not billed to Medicaid.
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