Primary Care Provider Practice Reassignment for Some Beneficiaries

Thursday, April 1, 2021

In preparation for NC Medicaid Managed Care launch on July 1, 2021, NCDHHS is working with primary care providers (PCPs) and other stakeholders to ensure that PCP practice assignments most accurately reflect existing provider-patient treatment relationships. As a result, NCDHHS has implemented a PCP practice reassignment process to better match beneficiaries to the PCP with whom they already have an active relationship with. This will help ensure the best health plan is selected during auto-enrollment.
 
The PCP practice reassignment process occurred March 20 and 21, 2021, and impacted only beneficiaries who have not visited their current PCP in the last two years and have an active treatment relationship with a different PCP. These beneficiaries were reassigned to the PCP with whom they are currently receiving care. This change affected approximately 150,000 beneficiaries.
 
New ID cards will be mailed to beneficiaries early April. The ID card will include the beneficiary’s new PCP. 

Beneficiaries who may want to change their PCP assignment should contact their Department of Social Services (DSS) caseworker who can reassign the beneficiary to the correct PCP. Beneficiaries can also call the Medicaid Contact Center at 888-245-0179 for assistance.  

PCPs actively caring for beneficiaries not assigned to their practice panel can help beneficiaries update their practice assignment. Practice staff may complete the Community Care of North Carolina/Carolina ACCESS Enrollment Form for Medicaid Recipient, ask the beneficiary to confirm the change with their signature on the form and fax the form to the local DSS office. 

Fax numbers and other contact information for local DSS offices can be found at https://www.ncdhhs.gov/divisions/social-services/local-dss-directory. In instances where issues persist or escalation is needed, practices are encouraged to contact the Medicaid Contact Center at 888-245-0179.

Contact

NC Medicaid Contact Center, 888-245-0179