Please note this bulletin was updated on June 17, 2021, to add the new phone number for the Provider Ombudsman.
In addition to the NC Medicaid Provider webpage, Medicaid and NC Health Choice providers now have a supplemental resource to research their questions and submit inquiries. The NC Medicaid Help Center is an online source of information about Managed Care, COVID-19 and Medicaid and behavioral health services, and is also used to view answers to questions from the NC Medicaid Help Center mailbox, webinars and other sources. Formerly referenced as the “SWAT Command Center,” the NC Medicaid Help Center also includes resource documents such as standard and COVID-19 Medicaid Bulletins. To use this new tool:
- Go to NC Medicaid Help Center
- Type a topic or key words into the search bar; or,
- Select a topic from the available list of Categories
The Bulletins category will search all Medicaid Bulletins for the topic of your choice.
FAQs are listed in categories from questions based on popular topics such as COVID-19, telehealth services, health plan enrollment, provider reimbursement, etc. Based on the entry or selection, the Help Center will return all related information. Providers may also select a topic from the Most-Viewed or Top-Rated articles section as available to find answers. The Help Center is continually updated as new information becomes available.
If, after using the NC Medicaid Help Center, the inquiry remains unresolved, use the below table to direct the question appropriately:
|
Question Type |
Timeframe |
Resource / Phone Number |
|
Provider Enrollment in Medicaid or North Carolina Health Choice |
Current Process – Ongoing –Future |
NCTracks Call Center at 800-688-6696. To update your information, please log into NCTracks (https://www.nctracks.nc.gov) provider portal to verify your information and submit a MCR or contact the GDIT Call Center. |
|
Provider Contracting Inquiries |
Current – Ongoing – Future |
Health Plans – Contact Info here: https://medicaid.ncdhhs.gov/transformation/health-plans/health-plan-contacts-and-resources |
|
Provider to PHP Contracting Concerns or Complaints |
Current – Ongoing |
Provider Ombudsman Email: Medicaid.ProviderOmbudsman@dhhs.nc.gov |
|
Prior Authorizations |
Before July 1, 2021 |
NCTracks Call Center at 800-688-6696 or log into NCTracks (https://www.nctracks.nc.gov [nctracks.nc.gov]) provider portal to update your information, submit a claim, review claims status, request a prior authorization or submit a question. |
|
Prior Authorizations |
Post July 1, 2021 |
Health Plans – Contact Info here: https://medicaid.ncdhhs.gov/transformation/health-plans/health-plan-contacts-and-resources |
|
Recipient Eligibility, Claims Processing, Billing Questions |
Before to July 1, 2021 |
NCTracks Call Center at 800-688-6696 or log into NCTracks (https://www.nctracks.nc.gov [nctracks.nc.gov]) provider portal to update your information, submit a claim, review claims status, request a prior authorization or submit a question. |
|
Recipient Eligibility, Claims Processing, Billing Questions |
Post July 1, 2021 |
Medicaid Direct NCTracks Call Center at 800-688-6696 Standard Plan Health Plans – Contact Info here: https://medicaid.ncdhhs.gov/transformation/health-plans/health-plan-contacts-and-resources |
|
What does the Medicaid Contact Center Help providers do? |
N/A |
The Medicaid Contact Center is dedicated to assisting with inquiries regarding enrollment, claim status, recipient eligibility and other information needed by providers to support their service to NC DHHS recipients. |
Contact
NC Tracks Contact Center: 800-688-6696