Topics Related to Personal Care Services Providers

Effective Nov. 01, 2021, all encounters subject to EVV will require an EVV visit history.

Final Extension of Electronic Visit Verification Soft Launch for Prepaid Health Plans

Providers rendering personal care services subject to EVV through the prepaid health plan payer type have until Oct. 1, 2021 to complete EVV credentialing and begin processing EVV claims.

To assist providers in navigating the managed care health plans' PCS referral and intake process, NC Medicaid has partnered with the health plans to implement a short-term solution for ACH providers who deliver PCS services.

The State solution for reporting electronic visit verification and aggregation is Sandata.

When an NC Medicaid Managed Care member becomes part of a population exempted or excluded, they are disenrolled and transition to NC Medicaid Direct.

Effective June 1, 2021, all personal care services (PCS) claims that were subject to the electronic visit verification (EVV) mandate must include visit data information before the claim can process to adjudication in NCTracks.

Effective July 1, 2021, some Medicaid beneficiaries receiving Personal Care Services (PCS) transitioned from NC Medicaid Direct to receiving services through an NC Medicaid Managed Care health plan.

NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021. A stakeholder meeting will be held on Friday, May 21, 2021, at 10 a.m. to share EVV implementation updates and provide training to support provider readiness for June 1, 2021.

NC Medicaid will end the pay and report period for Electronic Visit Verification (EVV) claims on May 31, 2021.