Topics Related to All Providers

Influenza Vaccine and Reimbursement Guidelines for 2021-2022 for NC Medicaid and NC Health Choice

Billing codes for Medicaid beneficiaries

Medicaid Claims Documentation: 2020 Single State Audit

Tips for providers to reduce the likelihood of future documentation errors

Single State Audit SFY2021

OSA has begun the Single Audit for state fiscal year 2021

In-Network Provisions Extended Through September

To support providers during the recent COVID-19 surge, the policy for in-network provider provisions has been extended

Rebate Eligible Prescription Drug Coverage by Prepaid Health Plans

PHPs are required to provide drug coverage to Medicaid beneficiaries consistent with the drug coverage determined by NC Medicaid under fee for service.

Claims Denied – Taxonomy Codes Missing, Incorrect, or Inactive

Taxonomy codes must be included when submitting claims to prepaid health plans

Tailored Care Management: Conflict-Free Care Management Guidance

Ensure compliance with the HCBS final rule and prepare Tailored Plans and Providers for the launch of Tailored Care Management.

Extension of Out-of-Network Provisions

The policy is extended through Nov. 30, 2021.

Expedited Hardship Advances for Managed Care Providers

May be available for those at risk of not meeting financial obligations

Billing Guidance for Children’s Developmental Services Agency Providers

Claims may be submitted to NCTracks for all IFSP services for dates of service starting on July 1, 2021.