Topics Related to Bulletins
When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.
Providers must submit ALL eyeglasses prior approval requests for NC Medicaid Direct beneficiaries and health plan members to NCTracks.
Guidance to pharmacies on prior authorizations that transfer from a health plan to NC Medicaid Direct.
Providers must submit a contact lens prior approval request to NCTracks for a beneficiary who has transferred back to NC Medicaid Direct.
Three Months Left to Submit Program Year 2021 Attestations and the Security Risk Analysis.
For clarification purposes of information communicated in October 2018 Medicaid Bulletin, please note that effective Oct. 1, 2018 the new 4-digit Long Acting Reversible Contraceptives (LARC) DRG code is not required to be submitted on the claim.
For Inpatient Hospital services the appropriate reimbursement process will begin after the claim has been grouped using the Grouper Software as usual. Either the original maternity DRG, or the LARC will be assigned systematically.
DHHS announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).
Actions providers should take to reduce claim denials and payment delays.
This bulletin provides important information regarding changes in the law concerning NC HealthConnex, the state-designated health information exchange.
While NC Medicaid works to resolve issues impeding the billing process for CDSA-Contracted Providers to NCTracks, providers who are at risk of not meeting financial obligations this month as a result of this delay may request a hardship advance to offset the business cost due to pended or denied claims.