The adjudication of some prior approvals will be performed by GDIT Fiscal Agent Operations Reviewers instead of clinical reviewers at NC Medicaid
Topics Related to Medicaid Direct
Evaluates the impact of the North Carolina Medicaid Transformation on primary care and obstetrics/gynecology (Ob/Gyn) practices
A delay in identifying individuals in NCTracks as dually eligible for Medicare and Medicaid has been discovered.
From Dec. 1, 2022, to June 30, 2023, they will receive an enhanced medical home payment of $20 per member per month.
Key milestones, playbook updates, verifying eligibility, reverification and more
NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.
Key milestones, playbook updates, verifying beneficiary eligibility, provider reverification, review provider record in NCTracks and more.
NC Medicaid Direct PA effective begin and end dates will be modified to align with the individual’s eligibility segment.
A new PA is required for beneficiaries returning to NC Medicaid Direct.
New billable codes available Sept.1 to address social drivers of health