Providers and pharmacies should always use NCTracks to confirm eligibility.
Topics Related to All Providers
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.
While NC Medicaid works to resolve issues impeding the billing process for CDSA-Contracted Providers to NCTracks, providers who are at risk of not meeting financial obligations this month as a result of this delay may request a hardship advance to offset the business cost due to pended or denied claims.
The updated Quality Strategy now incorporates the quality activities of all managed care plans, including the Behavioral Health I/DD Tailored Plans, the Eastern Band of Cherokee Indians (EBCI) Tribal Option and Community Care of North Carolina.