The NC Medicaid Ombudsman helps NC Medicaid beneficiaries understand Medicaid and NC Medicaid Managed Care. They can help beneficiaries when they are not able to solve problems with their provider or health plan.

They can help with:

Information and Education with Beneficiaries and Families

Answer questions through the NC Medicaid Ombudsman hotline and operate as an information and education access point for all Medicaid beneficiaries and their families.

Issue Resolution

Provide a warm handoff when there is a need to transfer a beneficiary to NC Department of Health and Human Services programs, the Enrollment Broker or health plan in the process of issue resolution.

Program Trend Monitoring

Identify program trends and issues and provide the NC Medicaid Contact Center/Help Desk with strategic solutions to assist the health plans and Enrollment Broker in addressing potential systemic issues across the NC Medicaid Managed Care delivery system.

Partner Engagement

Coordinate with community partners for external engagement activities. Requests will be referred to the NC Medicaid Office of Communications and Engagement for coordination.

Experienced Staff

The NC Medicaid Contact Center is staffed by experienced professionals. Staff members go through 6 weeks of detailed training to make sure they are ready to support Medicaid beneficiaries.

Call the NC Medicaid Ombudsman when you:

• Are not getting the care you need
• Have questions about a notice or bill
• Have talked with your provider or health plan and cannot solve a problem

Contact

To contact the NC Medicaid Ombudsman, call 1-877-201-3750 from 8 a.m. to 5 p.m., Monday through Friday except for State holidays.