B. Members

GUIDANCE DOCUMENTS FORMS AND TEMPLATES
Grievance and Appeals Process for Disenrollment Determinations (Feb. 4, 2019 | v1.0) Change in Member Circumstances Reporting Template and Instructions (Feb. 4, 2019 | v1.0)
NC Medicaid Style Guide (Feb. 5, 2019 | v2.0) Decision on Your Request for an Appeal: 2001-Final (March 20, 2019 | v1.0)
Neuro-Medical Center/Veterans' Home Admission: Disenrollment Alert Form and Process (Feb. 4, 2019 | v1.0) Decision on Your Request for an Appeal: 2001E-Final (March 20, 2019 | v1.0)
PHP Marketing Materials Code (May 19, 2019 | v3.0) Decision on Your Request for an Appeal: 2002-Final (March 20, 2019 | v1.0)
  Decision on Your Request for an Appeal: 2002E-Final (March 20, 2019 | v1.0)
  Decision on Your Request for an Appeal: HC-2001-Initial (March 20, 2019 | v1.0)
  Decision on Your Request for an Appeal: HC-2001-Final (March 20, 2019 | v1.0)
  Decision on Your Request for an Appeal: HC-2002-Final (March 20, 2019 | v1.0)
  Decision on Your Request for Services: 2001-Initial (March 20, 2019 | v1.0)
  Decision on Your Request for Services: 2001E-Initial (March 20, 2019 | v1.0)
  MEM001-J PHP Enrollment Detail Report File Transmission Layout (Feb. 20, 2019 | v1.0)
  MEM001-J PHP Enrollment Detail Report - Extract (Jan. 30, 2019 | v1.0)
  MEM001-J PHP Enrollment Summary Report (Jan. 30, 2019 | v1.0)
  MEM002-J Member Services Quality Assurance Report (Feb. 20, 2019 | v1.0)
  MEM003-J Member Marketing and Educational Activities Report (Jan. 30, 2019 | v1.0)
  MEM004-J Planned Marketing Procedures, Activities, and Methods (Jan. 30, 2019 | v1.0)
  MEM006-J Member Incentive Programs Report (Jan. 30, 2019 | v1.0)
  MEM007-J Member Appeal and Grievance Requests and Dispositions Report (Jan. 30, 2019 | v1.0)
  NC Medicaid Managed Care Member Handbook (Standard Plans) (May 31, 2019 | v3.0)
  Non-verifiable Member Addresses Reporting Template and Process Flow (Feb. 4, 2019 | v1.0)
  Notice of Change in Your Medicaid Services: 2002-Initial (March 20, 2019 | v1.0)
  Notice of Change in Your Medicaid Services: 2002E-Initial (March 20, 2019 | v1.0)
  Notice of Change in Your Health Choice Services: HC-2002-Initial (March 20, 2019 | v1.0)
  PHP-Initiated Disenrollment Form and Process Flow (Feb. 4, 2019 | v1.0)
  Returned Mail Reporting Template and Process Flow (Feb. 4, 2019 | v1.0)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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