Fact Sheets

Department Fact Sheets

Medicaid Transformation

• Introduction to Medicaid Transformation: Part 1 – Overview - June 14, 2021
• Introduction to Medicaid Transformation: Part 2 – Enrollment and Timelines - June 14, 2021
• Eastern Band of Cherokee Indians (EBCI) Tribal Option Overview - June 14, 2021
• What Providers Need to Know: Part 1 – Before Managed Care Launch - June 14, 2021
• What Providers Need to Know: Part 2 – After Managed Care Launch - June 14, 2021

Contracting

• Contracting with Health Plans - Jan. 4, 2021
• For more information, visit the Provider Contracting with Health Plans page. 

Member Enrollment

• What is Auto-Enrollment and How Does it Work? - May 25, 2021 - English | Spanish
• Managed Care Populations (Do I Need to Choose a Health Plan?) - April 29, 2021 - English | Spanish
• Member Enrollment Part 1 - Health Plan Auto-Enrollment - June 14, 2021
• Member Enrollment: Part 2 - Primary Care Provider (PCP)/Advanced Medical Home (AMH) Auto-Assignment - June 14, 2021
• Auto Enrollment Scenarios Presentation - Dec. 30, 2020

Enrollment Broker

• Medicaid and NC Health Choice Provider and Health Plan Lookup Tool - June 14, 2021
• For more information on the Enrollment Broker notices and beneficiary materials, visit the Beneficiary Materials page.

Non-Emergency Medical Transportation

• For Non-Emergency Medical Transportation (NEMT) fact sheets, please see the NEMT page on the County Playbook.

Programs and Services

• Panel Management - June 14, 2021
• Prompt Payment - March 31, 2021
• Managed Care PCP/AMH Provider Payment Matrix - June 14, 2021
• Health Equity Enhanced Payment Initiative - March 31, 2021
• Overview of Provider Directory Data Flow - March 18, 2021
• Managed Care Eligibility for Newborns: What Providers Need to Know - June 14, 2021
• Managed Care Claims and Prior Authorizations Submission: What Providers Need to Know - Part 1 - June 14, 2021
• Managed Care Claims and Prior Authorizations Submission: Frequently Asked Questions - Part 2 - June 14, 2021
• Telehealth Program - June 14, 2021
• Transition of Care for beneficiaries receiving long-term services and supports - June 14, 2021
• Advanced Medical Home - June 14, 2021
• Early Intervention Services in Medicaid Managed Care - March 1, 2021

AHEC Guides

MMC Checklist 

• For more information on AHEC practice support, visit the AHEC Practice Support page.

Health Plan Resources

• For additional health plan resources and contact information, visit the Health Plan Contacts and Resources page.
• For additional health plan training opportunities, visit the Provider Playbook: Training Courses page.

Quick Reference Guides 

Day One Provider Quick Reference Guide - June 14, 2021

AmeriHealth Caritas North Carolina
https://www.amerihealthcaritasnc.com/provider/forms/index.aspx

Carolina Complete Health
https://network.carolinacompletehealth.com/resources/manuals-and-forms.html

Healthy Blue (Blue Cross Blue Shield)
https://provider.healthybluenc.com/north-carolina-provider/manuals-and-guides

United Healthcare Community Plan of North Carolina
https://www.uhcprovider.com/en/health-plans-by-state/north-carolina-health-plans/nc-comm-plan-home/nc-cp-training.html

WellCare of North Carolina
https://www.wellcare.com/North-Carolina/Providers/Medicaid