Guidance for Providers Experiencing Payment Issues
Actions providers should take to reduce claim denials and payment delays

Actions providers should take to reduce claim denials and payment delays.

During the transition period after NC Medicaid Managed Care launch, providers may experience payment issues from an increase in claim denials. Providers should take the following actions to reduce claim denials and payment delays:

If a provider is unable to resolve claim payment issues through that process, they should follow the guidance below to contact the health plan.

Health Plan

PHP Guidance for Payment Issues

AmeriHealth Caritas (AMHC)

Providers are encouraged to call Provider Services at 888-738-0004 or to contact their dedicated Account Executive with any issues or concerns.

Providers may find the contact information for their dedicated Account Executive by downloading the PDF version of our network map available at https://www.amerihealthcaritasnc.com/assets/pdf/provider/acnc-account-executives-by-region.pdf

Carolina Complete Health (CCH)

Questions for financial concerns may be sent to: CCHNfundingrequest@cch-network.com

Healthy Blue

If a provider has questions about their claims submission or believes their claim has taken longer to process than the timelines outlined in the Healthy Blue Provider Manual, please contact the Healthy Blue Provider Relations team at 844-594-5072 or nc_provider@healthybluenc.com

United Healthcare (UNHC)

Your Provider Relations team is an important resource when you have questions. They are your single point of contact across all lines of business and benefit plans to help make your interactions with us easier and more efficient.

  • Provider Relations is available to provide education on policies, procedures, and the tools and resources that are available to make working with UnitedHealthcare as easy as possible.

  • Provider Relations can also help you understand our organization and direct any questions you may have about our business to the appropriate people.

Provider Services Contacts

Contracting Contacts

Sometimes, claims issues may result from contracting or participation issues. If you have questions about your network participation status, please contact our Network Contracting team. Be sure to include a description of your issue or question.
Contact: 
So_Atlantic_Phys_Contracting@uhc.com

WellCare (WCHP)

Send payment issue inquiries to ncproviderrelations@wellcare.com 

If a provider continues to have unresolved payment issues, they should contact the Provider Ombudsman at Medicaid.ProviderOmbudsman@dhhs.nc.gov or 866-304-7062. 

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