This bulletin applies to NC Medicaid Managed Care Standard Plans.
Blog Entry List
AMH Provider Manual May 2024 reflects all program modifications and changes that impact provider contracts and operations.
Provider Data Management / Credentialing Verification Organization (PDM/CVO) Solution New Launch Date of 2026.
Includes information on the New Launch Date for PDM/CVO, Healthy Opportunities Pilot, Provider Fact Sheets, Reverification Updates and more.
This bulletin applies to NC Medicaid Managed Care and NC Medicaid Direct.
Medicaid corrected the reimbursement issue and reprocessed claims for nerve conduction tests performed by physical therapists.
Training for Providers begins Friday, June 28. Additional dates are listed in this bulletin.
Effective retroactive to Jan. 1, 2022, CPT code 80050 will no longer be reimbursed.
The PDM/CVO solution will consolidate provider data management and coordinate provider enrollment, credentialing, and ongoing data maintenance.
Includes medical and pharmacy prior authorizations, out of network provider rates and rules, and primary care provider changes
Providers should review Clinical Coverage Policy 2A-1 for information on Hospital Observation
Usage of the Nicotine Replacement Therapy Protocol is Eligible for Clinical Services Reimbursement to Pharmacies.
Members may now select to receive Tailored Care Management from a provider with Transition to Community Living Distinction.
Feedback Requested on Proposed Approach
To support the SNF and ICF-IID reporting and collection of provider healthcare assessment data.
Expanding Pilot Eligibility to Members in NC Medicaid Direct in Pilot Regions