The PDM/CVO solution will consolidate provider data management and coordinate provider enrollment, credentialing, and ongoing data maintenance.
Topics Related to All Providers
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
Expanding Pilot Eligibility to Members in NC Medicaid Direct in Pilot Regions
States must revalidate the enrollment of all providers at least every five years to ensure the information on record is accurate and current.
The audit will sample fee-for-service claims collected for a full year – July 1, 2024, through June 30, 2025.
Recent State Plan Amendment outlines duties of a responsible third party