1915(i) Assessment Training Frequently Asked Questions (FAQs)

Tab/Accordion Items

Please refer to the training completed on the birth month cycle:

The 1915(i) assessment tool can have a wet signature (pen).

Comments are optional.

Question continued: How will Carelon know what type of assessment it is when it's an initial assessment or reassessment, since there's no option to select which type it is?

Answer: N/A start date is applicable to initial and reassessments and this will be pre-populated on the assessment form. The assessment tool now includes checkboxes for each assessment type.

For approvals: Carelon with send a secure email to the submitter with the email title “SECURE: 1915i waiver eligibility decisions- Approval dates ____-______”.

For denials: The email title will read: “SECURE: 1915i waiver eligibility decision”.

As of Oct. 1, 2026, the new assessment tool MUST be used.  Please follow your Health Plan’s implementation guidance.

Check the box next to the assessment type. 

Please follow your Health Plan’s process for utilization of the updated 1915(i) Assessment Tool. 

1915(i) Assessment Tool can be signed using a wet (pen) or digital signature.

Care Managers/Care Coordinators should refer to  the NC DHHS Records Management and Documentation Manual for guidance.
Records Management and Documentation Manual | NCDHHS

Beneficiaries/LRPs are not required to sign the 1915(i) Assessment Tool.

Care Managers/Care Coordinators are responsible for completing 1915(i) assessments.

As of Oct. 1, 2026, the 1915(i) Assessment Tool must be signed using a wet (pen) or digital signature.

Care Managers/Care Coordinators should refer to  the NC DHHS Records Management and Documentation Manual for guidance.
Records Management and Documentation Manual | NCDHHS

Question continued: Example: if their birthday is September but their 1915(i) expires in July, how do we address this?

Answer: Please refer to the training completed on the birth month cycle:

Please refer to the training completed on the birth month cycle:

As of Oct. 1, 2026, the new assessment tool MUST be used. The tool can be found at the following link: 1915(i) Assessment Version 3.0.

Please follow your Health Plan’s implementation guidance. 

The Word version of the 1915(i) Assessment Tool has been posted as well. 

Please refer to the 1915(i) Assessment Tool Companion Guide for guidance on how to complete the assessment tool.

1915(i) service providers should only reach out to the Care Manager or Health Plan for status of the 1915(i) assessment. 

Answer: Please refer to the training completed on the birth month cycle:

You will move forward with scheduling an assessment for the member. Do not delay completing an assessment for the member. 

1915(i) eligibility determination is not service specific and care managers should follow their Health Plan’s UM guidance on authorization of services. 

Please refer to the training completed on the birth month cycle:

Please refer to the training completed on the birth month cycle:

  • The Care Manager receives an email notification of 1915(i) eligibility.
  • The Health Plan and the member receive a letter notification of 1915(i) eligibility.
  • The 1915(i) service provider should contact the Care Manager or the Health Plan for 1915(i) eligibility status.  

Please refer to the training completed on the birth month cycle:

Yes. Email 1915(i) assessments to: NCMedicaid1915irequests@carelon.com. The address can be found on slide 4 of the presentation. 

No. The initial assessment should be completed for a beneficiary to new to 1915(i) services. An annual reassessment should be completed 60 days prior to the beneficiary’s birth month each year.

Comments are optional for Tables 1 and 2.  

Please refer to the training completed on the birth month cycle:

Please refer to the training completed on the birth month cycle:

Please refer to the training completed on the birth month cycle:

The comment boxes expand to include as much information as needed.

Please refer to your agency’s internal process for 1915(i) assessment tool submission.

The 1915(i) Assessment Training presentation and recording can be found here: Information for Tailored Care Management Providers | NC Medicaid, under 1915(i) Material then click 1915(i) Training.

Question continued: Besides "Traditional Gap Assessment", it states that "requested start date will be the day after the existing eligibility end date".  However, I need the start date to be the 1st date after their birth month.

Answer: Please refer to the training completed on the birth month cycle:

N/A start date is applicable to initial and reassessments and this will be pre-populated on the assessment form. The assessment tool now includes checkboxes for each assessment type.

The Care Manager only receives an email notification of 1915(i) eligibility. If  a member has been determined 1915(i) eligible, please refer to the training completed on the birth month cycle:

1915(i) Birth Month Training

1915(i) eligibility determination is not an authorization for 1915(i) services.

The Department does not require a diagnosis to be completed on the assessment tool.

Send email to Questions.NCMC1915i@carelon.com for status checks of 1915(i) assessments.

It is recommended this form be completed electronically.

1915(i) assessment has requirements as outlined in 42 Code of Federal Regulation (CFR) § 441.720

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This page was last modified on 09/25/2026