Blog Entry List
Key milestones, playbook updates, verifying eligibility, provider reverification, provider records, behavioral health services transition and more
Attention Standard Plans/Tailored Plans/HHA Exchange/CareBridge and Healthy Blue
Updates to Clinical Coverage Policy 1A-5 with an effective date of Sept. 2, 2022.
What services are available, in which regions, and how providers can refer patients.
Updates on Tailored Plan criteria review, eligibility criteria, enrollment and health care options, and resources for Beneficiaries and Providers.
Providers shall not bill a NC Medicaid beneficiary for services furnished to a beneficiary who the provider has accepted as a Medicaid patient.
NC Medicaid is working with Standard Plans to create easier pathways for providers to reach Standard Plans and resolve panel issues.
Service field location effective date change from Oct. 5, 2022, to Jan. 1, 2023
The PDAP Medicaid fee schedule requires multiple rate updates
CAHPS is a patient experience survey that serves as a national standard for measuring and reporting respondents’ experiences with their health care.
Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices
Quality metrics that will assess health plans’ performance across their populations
A delay in identifying individuals in NCTracks as dually eligible for Medicare and Medicaid has been discovered.
Updates for NC Immunization Program/Vaccines for Children and Medicaid Beneficiaries
Pharmacy Point of Sale claims for members enrolled Tailored Plans will be managed by NCTracks when Tailored Plans launch through March 31, 2023.