Key dates for transitioning to NC Medicaid Managed Care, Provider contracting reminders, Provider Playbook updates, Provider outreach to patient panels, webinars, Provider and health plan look-up tool, PHP quick reference guides, help center, Provider Ombudsman and Tailored Care Management certification.
Medicaid Bulletin
Medicaid Bulletin Monthly Digest
Articles beginning January 2018 are available in the blog format.
Providers with Denials for Healthy Opportunities Screening, Assessment and Referrals Claims due to edit 02088 may now resubmit claims; Place of Service Indicator codes updated.
NC Medicaid will offer time-limited payments to practices that have attested as an Advanced Medical Home Tier 3 if they can demonstrate successful readiness for AMH Tier 3 responsibilities.
Changes have been made to the Clinical Pharmacy Practitioners (CPPs) fee schedule to more accurately reflect the types of services provided by a CPP certified by the NC Board of Pharmacy.
The Department is releasing the draft Tailored Care Management Desk Review Guide and Scoring Tool to support providers applying for AMH+ or Care Management Agency certification.
To ensure NC Medicaid continues to move forward with EVV implementation and can fully integrate EVV through claims adjudication for all providers, alternate EVV solutions must pass testing validation by April 30, 2021.
This bulletin provides an update on the final reconciliation activity related to nursing facility staff COVID-19 testing payments authorized under Secretarial Orders No. 2 and No. 4.
Providing the most accurate and complete provider information is a top priority so Medicaid and NC Health Choice beneficiaries can make the most informed choice for their health plan and primary care provider.
NC Medicaid is making system modifications that will start the process of 45 and 60 day notifications of suspension if a provider fails to update their credential prior to the expiration date.
Effective with the date of service April 1, 2021, the Centers for Medicare & Medicaid Services added new HCPCS codes (J codes), deleted others and changed the description of some existing codes.