Not required for medications administered at the provider’s office or outpatient hospital clinic settings and billed as part of the professional claim (Physician Administered Drug Program).
Blog Entry List
The extension granted through the hardship process is now matched by the extension granted through new legislation.
All responses have been received and are available.
NC Medicaid advanced 54 providers to the site review stage.
Providers and pharmacies should always use NCTracks to confirm eligibility.
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.
The State solution for reporting electronic visit verification and aggregation is Sandata.
When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.
Key milestones, playbook updates, prior authorizations, FAQs, contracting, ombudsman, webinars and more.
Three Months Left to Submit Program Year 2021 Attestations and the Security Risk Analysis.
Actions providers should take to reduce claim denials and payment delays.
DHHS announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).
This bulletin provides important information regarding changes in the law concerning NC HealthConnex, the state-designated health information exchange.