Blog Entry List
Upcoming Key Milestone Dates, Playbook Updates, Request to Move to NC Medicaid Direct Process, Prior Authorizations, Frequently Asked Questions, Contracting Reminders, Ombudsman and Webinars
The week of October 11, Carolina Access practices will receive a new PCCM agreement from CCNC. Signing this agreement allows practices to receive or continue to receive practice assignment data or quality data for NC Medicaid Direct beneficiaries. This does not apply to Carolina Access providers participating in the EBCI Tribal Option.
Information for providers to prepare for the reporting year 2023 Payment Error Rate Measurement audit.
All state Medicaid programs are required to incorporate methodologies.
The NCTracks provider record serves as the source of truth for managed care entities.
Providers are encouraged to confirm which PA types are included in this long-term design.
This replaces the bulletin, published on Aug. 4, 2021
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.
Providers must submit ALL eyeglasses prior approval requests for NC Medicaid Direct beneficiaries and health plan members to NCTracks.
When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.
The State solution for reporting electronic visit verification and aggregation is Sandata.
Durable Medical Equipment (DME) is covered under NC Medicaid Managed Care for beneficiaries enrolled in a managed care plan and under NC Medicaid Direct for those beneficiaries who remain in NC Medicaid Direct.
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.
The following services should continue to be billed through NCTracks.