Topics Related to Medicaid Managed Care

Certified Tailored Care Management Providers Completed Readiness and Application Period Open for Round 3 Tailored Care Management Certification.
Join DHHS Sept. 29, 2022, at 3:30 p.m. for more information. Statement of intent due Nov. 10, 2022.
Providers should contact the PHPs and Provider Ombudsman to resolve issues.
Key milestones, playbook updates, verifying eligibility, provider reverification, provider records, behavioral health services transition and more
Attention Standard Plans/Tailored Plans/HHA Exchange/CareBridge and Healthy Blue
What services are available, in which regions, and how providers can refer patients.
Updates on Tailored Plan criteria review, eligibility criteria, enrollment and health care options, and resources for Beneficiaries and Providers.
NC Medicaid is working with Standard Plans to create easier pathways for providers to reach Standard Plans and resolve panel issues.
Provider manual update, guidance on position qualifications, phased assignment approach for Tailored Care Management providers and more.
NC Medicaid is sharing a list of member counts for Advanced Medical Home practices affiliated with Tailored Plans