NC Medicaid has received calls concerning claim denials for some services provided by nurse practitioners (NPs) and physician assistants (PAs).
Blog Entry List
Effective Oct. 1, 2019, two additional ICD-10 codes will be added to the LARC DRG reimbursement retroactive date of Oct. 1, 2018.
Providers must bill with the following HCPCS code, and the appropriate ICD-10 PCS code on the inpatient hospital claim to receive the LARC DRG reimbursement.
On Oct. 1, 2019, an amended version of Clinical Coverage Policy 5A-3, Nursing Equipment and Supplies, was posted to the North Carolina Medicaid website. In addition to correcting numbering, grammatical and style errors, several changes have been made.
On Jan. 29, 2013, NC Medicaid issued a memorandum giving guidance on the subject of Guidance for Family Supplementing Payment to the Medicaid Benefit. Several adult care home (ACH) providers have recently referenced this memorandum when inquiring about payment supplements specifically related to the provision of Personal Care Services (PCS) to recipients of special assistance.
Beginning Oct. 15, 2019, North Carolina Medicaid Bulletin articles will be delivered more often and in an online format. The improvements are in response to feedback from providers looking for a flexible way to receive important Medicaid information to better serve beneficiaries and more effectively operate their businesses.
*NOTE: THE CONTENT OF THIS BULLETIN IS AN UPDATE TO A MEDICAID SPECIAL BULLETIN PREVIOUSLY PUBLISHED ON SEPT. 5, 2019 REGARDING FLEXIBILITIES RELATED TO HURRICANE DORIAN.
This Special Bulletin includes several articles regarding Hurricane Dorian.
For inclusion in auto-enrollment, provider contracts must be signed and mailed to health plans no later than Nov. 15, 2019.
For inclusion in auto-enrollment, provider contracts must be signed and mailed to the health plans no later than Nov. 15, 2019. A list of questions and answers is provided for reference regarding this deadline.
NC Medicaid will reprocess claims with dates of service between Jan. 1, 2019 and Sept. 3, 2019, paid to primary care physicians, nurse practitioners and physician assistants submitted with E&M codes ranging from 99201 to 99499 and the corresponding taxonomies as defined in Section 1202 of the Affordable Care Act (ACA).
*NOTE: THE CONTENT OF THIS BULLETIN HAS BEEN UPDATED. REFER TO THE SEPT. 24, 2019 MEDICAID SPECIAL BULLETIN FOR REVISED FLEXIBILITIES.
This Special Bulletin includes several articles regarding Hurricane Dorian.
As of the end of August 2019, several issues have been identified with the search function in the Enrollment Broker Provider Directory, including duplicate results, and difficulty finding doctors based on specific criteria such as gender or name.
The Department of Health and Human Services (DHHS) recently launched an online “Provider Playbook” as part of its commitment to ensure providers have resources to help Medicaid beneficiaries transition smoothly to Medicaid Managed Care. This new Provider Playbook is a collection of information and tools specifically tailored to providers.
Supporting beneficiaries in their transition between the current fee-for-service delivery system and NC Medicaid Managed Care is called transition of care. The transitional period surrounding the launch of Medicaid Managed Care is referenced as crossover.
The North Carolina Division of Health Benefits (DHB) would like to reiterate the 340B provider and claim submission requirements for both the outpatient pharmacy and Physician’s Drug Program (PDP).
The NC Medicaid EHR Incentive Payment System (NC-MIPS) is only accepting Program Year 2019 Stage 3 Meaningful Use (MU) attestations. All eligible professionals (EPs) attesting in Program Year 2019 will be required to attest to Stage 3 MU and use a 2015 Edition of certified EHR technology (CEHRT).