Expedited Provider Access to Pain Management Plus

No special forms required—just send us your request, along with the patient’s demographics and records, and we’ll promptly schedule an appointment.
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We know patient care can be complex, but access shouldn’t be. As a provider, you understand the importance of getting patients scheduled and evaluated quickly, especially those dealing with pain or addiction. At Pain Management Plus, we share that understanding. Refer your patient today, and we’ll ensure a swift evaluation, followed by a timely assessment sent directly to you, so you can stay involved and informed throughout the process.

PHONE
​(828) 919-2393

FAX
​(888) 284-2932

EMAIL
[email protected]

Insurance Information

At Pain Management Plus, we are in-network with most major insurance plans, and in most cases, referrals are not required to schedule an appointment. However, there are some exceptions based on the specific details of your insurance plan.
For example, plans that offer HMO (gatekeeper) products may require a referral from your designated Primary Care Provider (PCP). In these cases, your PCP must submit the referral directly to your insurance plan before they will authorize visits to a specialist or other providers. Additionally, your plan may have certain restrictions on where you can receive outpatient services such as lab work, radiology, or physical, speech, and occupational therapy.

Please note:
It is the patient’s responsibility to understand your insurance plan’s specific requirements, coverage limitations, and restrictions. We strongly encourage you to contact your insurance company directly before scheduling an appointment, especially if you’re unsure of your plan’s details.
To verify your benefits, network status, and out-of-pocket costs (such as copayments, deductibles, or coinsurance), use the customer service number listed on the back of your insurance card. Be sure to provide them with our Group NPI (National Provider Identifier):
Group NPI: 1215596135

Understanding your coverage ahead of time can help avoid unexpected costs and ensure a smoother experience when you visit us. If you have additional questions after speaking with your insurance provider, feel free to contact our office—we’re here to help.

🛡️​ In Network Plans

We are proud to participate with a wide range of insurance carriers to help make your care accessible and affordable. Below is a list of plans we are currently in network with. Coverage may vary by plan type, so we encourage all patients to verify benefits and copay amounts with their insurer directly.

✅ Aetna Commercial Plans
✅ Aetna Medicare
✅ Alignment Health (effective 08/01/2025)
✅ Ambetter
✅ AmeriHealth Caritas NC (NC Medicaid Managed-Care Plan)
✅ AmeriHealth NEXT
✅ Appalachian Benefit Associates
✅ Blue Cross Blue Shield PPO, Indemnity, and Blue Value Plans (effective 10/16/2023) — ‘Specialist’ copays apply
✅ Blue Medicare (effective 10/16/2023)
✅ BWC (Bureau of Workers Compensation)
✅ Carolina Complete Health (NC Medicaid Managed-Care Plan)
✅ Cigna PPO
✅ Cigna Open Access
✅ Cigna HealthSpring
✅ Coventry
✅ Devoted Health (effective 01/01/2024)
✅ Healthgram
✅ Healthy Blue (NC Medicaid Managed-Care Plan)
✅ Humana/Choice Care Commercial Plans
✅ Humana/Choice Care Medicare Advantage HMO
✅ Humana/Choice Care Medicare Advantage PPO
✅ Humana/Choice Care Medicare Advantage PFFS
✅ MedCost
✅ Medicaid (North Carolina)
✅ Medicaid (South Carolina) — Limited to the original SC Medicaid plan only
✅ Medicare
✅ All Medicare Supplement Plans
✅ MultiPlan
✅ One Net PPO (Workers’ Compensation)
✅ Partners (NC Medicaid Managed-Care Plan)
✅ Railroad Medicare
✅ Tricare East SELECT
✅ Tricare East PRIME — Certified Non-Network; deductibles and cost share apply
✅ Tricare for Life
✅ Trillium (NC Medicaid Managed-Care Plan)
✅ TriWest (VA Community Care Network) — Referrals from the VA are required
✅ Troy Medicare Plans
✅ United Healthcare Standard Commercial Plans
✅ United Healthcare Options PPO
✅ Vaya (NC Medicaid Managed-Care Plan)
✅ WellCare Medicaid (NC Medicaid Managed-Care Plan)
✅ WellCare Medicare
✅ WellPath
✅ WNC Health Coalition

🛡️ Out-of-Network Insurance Plans

Some insurance plans are considered out of network due to limitations set by the insurance carrier—not by our practice. When this is known in advance, patients are expected to pay at the time of service. If payment is not collected during the visit, the balance will be billed and must be paid before or at your next appointment.
We can still file claims to these out-of-network plans, but coverage typically falls under out-of-network benefits, if applicable. If you still have any questions or concerns, you should contact your insurance provider directly to confirm your benefits and coverage by providing them our NPI# 1215596135.
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You may also consider:
📞 Contacting your insurance plan to verify your out-of-network benefits
📝 Asking your plan for an exemption to receive care from our practice
📬 Nominating our practice to be added to your plan’s network


❌ Aetna CVS Plans – Limited network plan created and restricted by Aetna
❌ Bright Health – No longer offered in North Carolina
❌ Crescent – As of 04/01/2025, No longer offered in North Carolina
❌ Friday Health Plans – No longer offered in North Carolina
❌ HealthTeam Advantage Plans – Closed network; not offering participation to new/additional providers
❌ UnitedHealthcare Medicare – Closed network; not offering participation to new/additional providers
❌ Out-of-State Medicaid Plans – (e.g., Tennessee, Georgia, Virginia)