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.
DHHS announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).
The updated Quality Strategy now incorporates the quality activities of all managed care plans, including the Behavioral Health I/DD Tailored Plans, the Eastern Band of Cherokee Indians (EBCI) Tribal Option and Community Care of North Carolina.
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.
The U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) to permit the emergency use of the unapproved product sotrovimab monoclonal antibody (MAB) for the treatment of certain patients.
NC Medicaid is extending COVID-19 temporary provider rate increases for all providers except hospitals through Sept. 30, 2021.
CMS has added new HCPCS codes (J Codes), deleted others and changed the description of some existing codes.
All Carolina Access Providers who received health equity payments are asked to take 5-10 minutes to complete a survey by Friday, July 30, 2021. The survey allows DHHS to monitor and evaluate how these payments were used.
Prepaid Health Plans (PHPs) began providing non-emergency medical transportation (NEMT) and non-emergency ambulance transportation (NEAT) services for PHP members on July 1, 2021.
Health plans have identified a common billing error of providers submitting professional and institutional EDI claims.
Data system guidance and strategy Q&As are now available
Effective with date of service May 17, 2021, Medicaid and NC Health Choice cover dostarlimab-gxly injection.
Effective July 29, 2021, Session Law 2021-62 (NC Senate Bill 594), repeals portions of the 2020 COVID-19 Recovery Act that permitted the temporary lifting of certain enrollment requirements for providers enrolling in NC Medicaid during the global healthcare emergency.
ADDENDUM to Special Bulletin #168: The addendum was updated to include information regarding guidance on billing and coding criteria, guidance for parents, counseling methods, reimbursement ranges and the time frame during which the code is valid.