Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices
Blog Entry List
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.
From Dec. 1, 2022, to June 30, 2023, they will receive an enhanced medical home payment of $20 per member per month.
Key milestones, playbook updates, verifying eligibility, reverification and more
Independent laboratories shall bill services to the hospital for whom they are providing clinical lab services. Hospitals should bill the PHPs.
Guidance published with examples, training and certification opportunities
NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.
Key milestones, playbook updates, verifying beneficiary eligibility, provider reverification, review provider record in NCTracks and more.
Providers who do not contract with Tailored Plans by the deadlines risk losing patients
A new PA is required for beneficiaries returning to NC Medicaid Direct.
NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.
New billable codes available Sept.1 to address social drivers of health
Prior to submitting an application for Advanced Medical Home/Care Management Agency Certification, please download and utilize the Provider Directory Listing Report.