Fact Sheets
Department Fact Sheets
Standard Plans
- Introduction to Medicaid Transformation: Part 1 – Overview - June 14, 2021
- Introduction to Medicaid Transformation: Part 2 – Enrollment and Timelines - June 14, 2021
- What Providers Need to Know: Part 1 – Before Managed Care Launch - Oct. 4, 2021
- What Providers Need to Know: Part 2 – After Managed Care Launch - Oct. 4, 2021
Tribal Option
Tailored Plans
- Tailored Care Management - May 23, 2023
- Tailored Plan Enrollment and Timeline - Apr. 25, 2023
- What Providers Need to Know Before Tailored Plan Launch - April 25, 2023
- What Providers Need to Know After Tailored Plan Launch - May 22, 2023
Standard Plans and Tribal Option
- Contracting with Health Plans - Jan. 4, 2021
Tailored Plans
- Contracting with Tailored Plans - Apr. 25, 2023
- Tailored Plan Provider Contracting Deadlines Questions and Answers - Apr. 25, 2023
For more information, visit the Provider Contracting with Health Plans page.
Disenrollment / Move to NC Medicaid Direct
- Request to Move to NC Medicaid Direct Process - Mar. 16, 2023
Standard Plans
- 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 - Oct. 4, 2021
- Member Enrollment: Part 2 - Primary Care Provider (PCP)/Advanced Medical Home (AMH) Auto-Assignment - Oct. 4, 2021
- Auto Enrollment Scenarios Presentation - Dec. 30, 2020
Tailored Plans
- Tailored Plan Member Enrollment: PCP Auto-assignment - May 4, 2023
- Tailored Plan Auto-Enrollment & Opt-In Scenarios - May 30, 2023
Continuous Coverage Unwinding
Enrollment Broker Information
- Medicaid and NC Health Choice Provider and Health Plan Lookup Tool - April 17, 2023
- For more information on the Enrollment Broker notices and beneficiary materials, visit the Beneficiary Materials page.
Non-Emergency Medical Transportation (NEMT)
For facts sheets regarding Non-Emergency Medical Transportation (NEMT), please see the NEMT page on the County Playbook
NC Medicaid Programs and Services
- Managed Care Claims Submission: What Providers Need to Know – Part 1 - May 17, 2023
- Provider Payment and Reimbursement - April 20, 2023
- NC Health Choice Move to Medicaid - April 26, 2023
- NC Health Choice Move to Medicaid Questions and Answers Fact Sheet - March 21, 2023
- NC Medicaid Managed Care: Provider Training - April 26, 2023
- Advanced Medical Home - Nov. 14, 2022
- Transition of Care - April 17, 2023
- Nursing Facility - Health Plan Process - Oct. 17, 2022
- Nursing Facility Placement - Oct. 17, 2022
- Provider Postpartum - March 21, 2022
- Children and Youth Transitioning to Foster Care for Providers - April 21, 2023
- What Providers Need to Know About Pharmacy - May 17, 2023
- Tailored Plan Managed Care Claims and Prior Authorizations Submission:
Frequently Asked Questions – Part 2 – May 16, 2023 - Managed Care Claims and Prior Authorization Submission: Frequently Asked Questions - Part 2 - Sept. 9, 2021
- Panel Management - Sept. 14, 2022
- Prompt Payment - May 17, 2023
- Managed Care PCP/AMH Provider Payment Matrix - June 14, 2021
- Health Equity Enhanced Payment Initiative - March 31, 2021
- Overview of Provider Directory Data Flow - Sept. 27, 2022
- Managed Care Eligibility for Newborns: What Providers Need to Know - Jan. 9, 2023
- Protections for Pregnant Women and Newborns - Dec. 19, 2022
- Telehealth Program - June 14, 2021
- Transitioning 1915(b)(3) Services to 1915(i) Authority: Service Providers - April 2023
- Transitioning1915(b)(3) Services to 1915(i) Authority: Tailored Care Management Providers - April 2023
- 1915(i) Tailored Care Manager Assessment Training - May 2023
- North Carolina’s Transition of 1915(b)(3) Benefits to 1915(i) - May 16, 2023
Visit the New Provider Data Management and Credentialing Verification Organization page for information on a new solution to align North Carolina’s credentialing process with the National Committee for Quality Assurance Standards.
AHEC Guides
AHEC Practice Support
For more information on AHEC practice support including the Back Porch Series, visit the AHEC Practice Support page.
Health Plan Resources
Additional 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.
Health Plan Quick Reference Guides -
Standard Plans:
Standard Plan Launch - Day One Provider Quick Reference Guide - updated Feb. 28, 2022
AmeriHealth Caritas North Carolina
amerihealthcaritasnc.com/provider/forms/index.aspx
Carolina Complete Health
network.carolinacompletehealth.com/resources/manuals-and-forms.html
Healthy Blue (Blue Cross Blue Shield)
provider.healthybluenc.com/north-carolina-provider/manuals-and-guides
United Healthcare Community Plan of North Carolina
uhcprovider.com/en/health-plans-by-state/north-carolina-health-plans/nc-comm-plan-home/nc-cp-training.html
WellCare of North Carolina
wellcare.com/North-Carolina/Providers/Medicaid
Tailored Plans:
Tailored Plan Launch - Day One Provider Quick Reference Guide
Alliance Health
alliancehealthplan.org/providers/network/provider-quick-reference-guide/
Eastpointe
eastpointe.net/providers/
(Fact sheet can be found under the Eastpointe Contact Fact Sheet tab)
Partners
partnersbhm.org/wp-content/uploads/partners-health-management-quick-reference-guide.pdf
Sandhills
sandhillscenter.org/for-providers/
(Fact sheet can be found under the Quick Reference Guide – Excel File tab)
Vaya
providers.vayahealth.com/resources/vaya-quick-reference-guide/
This page was last modified on 05/30/2023