The latest information providers need to know about the transition to Medicaid Managed Care. Update includes the Provider Directory and Health Plan Look-Up Tool, contracting reminders, Provider Playbook updates, upcoming webinars and more.
Topics Related to Medicaid Managed Care
Additional criteria has been added to identify beneficiaries as eligible for Behavioral Health I/DD Tailored Plans.
Effective April 1, 2021, as part of the transition to Medicaid Managed Care, NC Medicaid will offer time-limited payment to practices that have attested into Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.
The public version of the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool is now available. Providers are encouraged to use this tool to confirm the availability and accuracy of information contained in their NCTracks provider enrollment record.
As Medicaid and NC Health Choice transition to managed care, beneficiaries will be notified to select a Prepaid Health Plan as well as a Primary Care Provider/Advanced Medical Home. Beneficiaries who do not self-select will be auto assigned by the Department.
The Tailored Care Management certification process is now open, and providers may submit applications.
Key dates for transitioning to Medicaid Managed Care, contracting reminders, webinar series for providers and practice leaders, review your provider records in NCTracks, the Provider Ombudsman, PHP manuals updated and the beneficiary portal.
Provider webinars in December include Advanced Medical Home on December 10, COVID-19 Vaccine Distribution on December 15, and Behavioral Health on December 17.
The Department is releasing a Notice of AMH Policy Changes requiring modifications to Advanced Medical Home Provider Contract Templates memo.
Key dates, webinar series, Provider Directory tool, Provider Ombudsman and PHP manuals updated.