Carolina Behavioral Health

Name

Carolina Behavioral Health

Legal name

Carolina Behavioral Health Alliance, LLC

Website

https://cbhallc.com

Company type

Private

Operating status

Operating

Headcount range

1–10 employees

Ownership category

akta.pro rank

Product category

Managed Behavioral Healthcare Services

NAICS

Outpatient Mental Health and Substance Abuse Centers (621420)

SIC

Services-Misc Health & Allied Services, Nec (8090)

akta.pro primary industry

Behavioral Health Benefit Administration (MBHO Core) (HLAEAHAA)

akta.pro secondary industry

Behavioral Health Utilization Management & Care Authorization (HLAEAHAD)

Keywords

• Managed behavioral health
• Behavioral health benefits
• Claims administration
• Mental health services
• Substance use treatment

Headquarters

HQ city

Winston Salem

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Others

Revenue model

1. Managed Behavioral Health Administration: CBHA processes behavioral health claims for health plan members, coordinating mental health and substance abuse services. The organization is owned by three not-for-profit medical schools (Wake Forest Baptist Health, UNC Health Care, East Carolina University) and provides quality services at competitive rates through its relationship with academic medical centers.

Go-to-market motion1 record

Distribution channels3 records

Marketing channels2 records

Core offering

Carolina Behavioral Health Alliance (CBHA) is a provider-owned managed behavioral health organization that administers behavioral health benefits and processes claims for mental health and substance use services on behalf of regional health plans. It coordinates a network of credentialed behavioral health providers, performs member eligibility verification and triage, handles prior authorizations, and manages grievances and appeals for members across North Carolina and parts of South Carolina.

Product overview

Carolina Behavioral Health Alliance (CBHA) is a provider-owned managed behavioral health organization that offers a unified service platform for coordinating mental health and substance abuse care. The portfolio consists of integrated operational modules: claims processing (paper/electronic), provider network management with credentialing, prior authorization services (psychological testing, TMS), member eligibility and triage, out-of-network claim filing, grievance/appeal processing, and provider communications. All services are oriented toward behavioral health claims and care coordination for North Carolina and South Carolina populations, with operations ceasing by June 30, 2026.

Differentiator

Problem solved

Functional benefit

Named customers4 records

Segments3 records

Ideal customer profiles3 records

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Integration4 records

Partnerships

Seven partnerships are on record, tiered core and minor.

• Wake Forest Baptist HealthcoreStrategic or Co-development PartnerOne of three owners of CBHA. Being owned by this not-for-profit academic medical center enables CBHA to provide quality services at competitive rates. The relationship is aimed at improving the delivery of behavioral health services through research and education.
• UNC Health CarecoreStrategic or Co-development PartnerOne of three owners of CBHA. The academic medical center relationship enables CBHA to provide quality services and improve behavioral health service delivery to North Carolina citizens through research and education.
• East Carolina UniversitycoreStrategic or Co-development PartnerOne of three owners of CBHA. The university relationship supports CBHA's mission of improving behavioral health services delivery through research and education in North Carolina and parts of South Carolina.
• ClaimsnetcoreTechnology or IntegrationElectronic claims clearinghouse used by CBHA for processing electronic claims submissions. Providers can register through Claimsnet to submit electronic claims to CBHA at no cost.
• MedcostcoreTechnology or IntegrationProcesses payments and EOBs (Explanations of Benefits) for ATRIUM and Wake Forest Baptist Baptist Health plan members through CBHA.
• ECHOcoreTechnology or IntegrationECHO checks platform partnered with CBHA for WFU plan payments. Providers must have received a plan payment, know the payment amount, draft number, and Tax ID to register.
• Meritain/AetnaminorChannel Partner/ Reseller/ DistributorCBHA is directing providers who wish to serve Atrium members in 2026 to work with Meritain/Aetna for credentialing with their panel, as CBHA winds down operations.

Scale indicators3 records

Recent moves4 records

Broad incumbents

• Humana Behavioral Health: Managed care organization administering behavioral health benefits for its commercial and Medicare members, including utilization management and provider network administration. Same MBHO service category as CBHA, scaled nationally.
• Magellan Health: Specialty managed care company with a large behavioral health segment providing benefits administration, care management, and integrated health solutions. Directly comparable MBHO core service offering.
• Anthem Behavioral Health: Managed behavioral health services arm of one of the largest U.S. health insurers, handling utilization management, claims, and provider network services. Functionally equivalent to CBHA at much larger commercial scale.
• Carelon Behavioral Health (formerly Beacon Health Options): National MBHO offering utilization management, claims administration, and provider network management for behavioral health. Operates the same MBHO core model CBHA executes at a regional level.
• Centene Behavioral Health: Behavioral health administration capability within a major government-sponsored managed care company, handling Medicaid and Marketplace behavioral benefits. Provides overlapping MBHO services at significantly greater scale.
• Cigna Behavioral Health (Evernorth): The behavioral health arm of Evernorth/Cigna that administers mental health and substance use benefits for employer-sponsored and individual plans. Provides the same MBHO services CBHA offers but at national employer scale.
• Optum Behavioral Health: The largest U.S. managed behavioral health organization, administering benefits, claims, and care coordination for tens of millions of members. Directly comparable business model to CBHA but at vastly greater national scale and with broader payer relationships.
• Aetna Behavioral Health: National payer-owned behavioral health management operation, and the entity CBHA is directing providers toward for 2026 Atrium member service. Closest incumbent competitor absorbing CBHA's sunsetting book of business.

Direct peers

• PerformCare: Managed behavioral health organization that administers benefits, manages provider networks, and performs utilization review for public and commercial health plans. Comparable regional MBHO operating model.
• New Directions Behavioral Health: Regional MBHO providing behavioral health benefits administration, claims processing, and care coordination for health plans and employer groups. Closely mirrors CBHA's regional MBHO model and service mix.

Market position

Strengths1 record

Weaknesses5 records

Competitive moat3 records

Key risks5 records

Key highlights5 records

Customer concentration

Compliance1 record

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Carolina Behavioral Health