In response to provider concerns about on-going member assignment and panel management issues for Advanced Medical Homes (AMHs), NC Medicaid is working with the Standard Plans to analyze errors and create easier pathways for providers to reach Standard Plans and resolve panel issues.
- Standard Plans updated their contact information for providers to contact with panel questions or issues.
- Standard Plans are working to ensure their member and provider call lines are well equipped to respond to calls related to AMH assignment.
- Providers can also discuss panel limits with Standard Plans so they understand any panel limits they currently have with the plan based on initial contracting and can update panel limits, as needed. See the Panel Management for Advanced Medical Homes in Standard Plans fact sheet for general information on updating panel limits.
As a reminder, AMHs agree to accept assigned patients as part of their Medicaid enrollment, in addition to having the ability to limit panel sizes; therefore, new members can be assigned monthly within those practice panel limits. Many Medicaid members are currently unengaged with any primary care provider (PCP) and AMHs may not have a current treatment relationship with all of their assigned members.
Tier 3 AMHs are encouraged to use care management resources to help engaged new members and help assist members with barriers to accessing care. AMHs should also discuss unengaged member issues and strategies with their Standard Plans. NC Medicaid will continue to work with Standard Plans and AMHs to help get more members engaged in primary and preventative care.
Additional information on panel management is provided in the Panel Management for Advanced Medical Homes in Standard Plans fact sheet.
Contact
NC Medicaid Contact Center: 888-245-0179