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.
Blog Entry List
This Special Bulletin is being released to inform NC Medicaid providers of COVID-19 rate reimbursement that providers will receive from Prepaid Health Plans (PHPs) under NC Medicaid Managed Care.
This is a reminder to include taxonomy codes when submitting claims to PHPs, either by individual providers or through a trading partner.
This Bulletin includes key milestone dates for NC Medicaid Managed Care, Provider Playbook updates, prior authorization updates, contracting reminders, information about health plan events, the provider ombudsman and upcoming AHEC events and webinars. It also includes information about the Provider and Health Plan Lookup Tool, PHP Quick Reference Guide and the NC Medicaid Help Center.
A new clinical coverage policy, 1S-5 Genetic Testing for Susceptibility to Breast and Ovarian Cancer, became effective July 1.
Carolina Access Providers who received health equity payments are asked to complete this survey by July 16.
Additional information on prior authorization is available.
Updates to Clinical Coverage Policy 10B, Outpatient Specialized Therapies, Independent Practitioners
On July 1, 2021, an amended version of the policy was posted.
Four Months Left to Submit Program Year 2021 Attestations and the Security Risk Analysis.
The goal for Day One is that people get the care they need and providers get paid.
NC Medicaid wants to ensure that during the transition to NC Medicaid Managed Care that Medicaid beneficiaries receive the care they need as scheduled prior to July 1.
NC Medicaid is extending COVID-19 temporary provider rate increases for all providers except hospitals and clinical coverage policies through July 31, 2021.
An amended version of Clinical Coverage Policy 10C, Outpatient Specialized Therapies, Local Education Agencies is posted with an effective date of June 15, 2021.
Recent changes to federal regulations impact requirements for fingerprint-based background checks for some providers.
NCTracks continues sending notifications to update the identified provider’s expiring credentials in order to avoid suspension and potential termination from NC Medicaid.