This Bulletin includes key milestone dates for NC Medicaid Managed Care, Provider Playbook updates, prior authorization updates, contracting reminders, information about health plan events, the provider ombudsman and upcoming AHEC events and webinars. It also includes information about the Provider and Health Plan Lookup Tool, PHP Quick Reference Guide and the NC Medicaid Help Center.
Topics Related to Medicaid Managed Care
This is a reminder to include taxonomy codes when submitting claims to PHPs, either by individual providers or through a trading partner.
This Special Bulletin is being released to inform NC Medicaid providers of COVID-19 rate reimbursement that providers will receive from Prepaid Health Plans (PHPs) under NC Medicaid Managed Care.
Additional information on prior authorization is available.
NC Medicaid wants to ensure that during the transition to NC Medicaid Managed Care that Medicaid beneficiaries receive the care they need as scheduled prior to July 1.
The goal for Day One is that people get the care they need and providers get paid.
Frequently Asked Questions for NC Medicaid Managed Care
The following services should continue to be billed through NCTracks.
This bulletin provides guidance to nursing facilities serving NC Medicaid-only residents transitioning to managed care on July 1.
Key milestone dates, where to turn for help, Provider Playbook, PHP quick reference guides, webinars, Provider Directory, Help Center and Provider Ombudsman.