Tailored Plan Panel Membership NC Medicaid is sharing a list of member counts for Advanced Medical Home practices affiliated with Tailored Plans
To provide continuity of service to members and support the contracting efforts of Behavioral Health and Intellectual/Developmental Disabilities (I/DD) Tailored Plans with primary care providers (PCPs), NC Medicaid is sharing this list of member counts for Advanced Medical Home (AMH) practices (by NPI + location code) affiliated with Tailored Plans as of Dec. 1, 2022.
- NPI and Location Code
- Name of Provider
- Provider Address
- Tailored Plans of the members based on current member address
- Currently Assigned Panel Count of Members and their projected Tailored Plan. This number can change in future based on member eligibility at the time of actual enrollment with Tailored Plans.
Please note: providers who have a panel size of 10 members or fewer were not included in this list
This list provided is from an initial analysis and is intended to be used for Tailored Plan contracting purposes only. The Department expects the numbers of members assigned to each PCP/Tailored Plan to change at launch as new Members enroll in Medicaid, Members become Tailored Plan eligible, and as Tailored Plan eligibility is reassessed.
As shared in the NC Medicaid Managed Care: Contracting with Tailored Plans Provider fact sheet, choice period began on Aug. 15, 2022. PCPs/AMHs must have full executed contracted with Tailored Plans by Sept. 15, 2022, to be included in Tailored Plan Primary Care Auto-Assignment.
NC Medicaid strongly encourage PCPs/AMHs to work with the respective Tailored Plans to meet the contracting deadlines to support continuity of service for your assigned patients.
NC Medicaid Contact Center: 888-245-0179