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).
Topics Related to All Providers
The extension granted through the hardship process is now matched by the extension granted through new legislation.
Providers and pharmacies should always use NCTracks to confirm eligibility.
Key milestones, playbook updates, prior authorizations, FAQs, contracting, ombudsman, webinars and more.
When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.
Guidance to pharmacies on prior authorizations that transfer from a health plan to NC Medicaid Direct.
Three Months Left to Submit Program Year 2021 Attestations and the Security Risk Analysis.
DHHS announced the selection of seven organizations to serve as Behavioral Health and Intellectual/Developmental Disability Tailored Plans (Behavioral Health I/DD Tailored Plans).
Actions providers should take to reduce claim denials and payment delays.
This bulletin provides important information regarding changes in the law concerning NC HealthConnex, the state-designated health information exchange.