Fact Sheets

What Providers Need to Know Before Children and Families Specialty Plan Launch (Part 1)

Fact Sheet What Providers Need to Know After Tailored Plan Launch

Tailored Plan - Provider Quick Reference Guide

Standard Plan - Provider Quick Reference Guide

Department Fact Sheets

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Enrollment Broker Information

NC Medicaid Provider and Health Plan Lookup Tool - Feb. 28, 2024
For more information on the NC Medicaid 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

Medicaid Services for Justice-Involved Youth Per Section 5121 of the 2023 Consolidated Appropriations Act - March 24, 2025
Processes and Frequently Asked Questions for 1915(i) Services - Jan. 13, 2025
Tailored Care Management NC Medicaid Direct / Managed Care Enrollee Report - July 25, 2024
Tailored Plan Managed Care Claims and Prior Authorizations Submission:
Frequently Asked Questions – Part 2 - May 30, 2024
LME/MCO Consolidation Overview and FAQs – For Providers - January 2024
What Providers need to know about Medicaid Expansion - Sept. 19, 2023
NCCARE360-Healthy Opportunities (HOP) talking points - Sept. 5, 2023
Enrollee Report Updates for Primary Care Practices in Advance of Tailored Plan Launch - June 24, 2024
Home and Community Based Service Monitoring Tool Training - June 16, 2023
Managed Care Claims Submission: What Providers Need to Know – Part 1 - June 27, 2024
Provider Payment and Reimbursement - March 4. 2024
NC Health Choice Move to Medicaid - Feb. 28, 2024
NC Health Choice Move to Medicaid Questions and Answers Fact Sheet - March 21, 2023
NC Medicaid Managed Care: Provider Training - Feb. 28, 2024
Advanced Medical Home - Nov. 14, 2022
Transition of Care - March 15, 2024
Nursing Facility - Health Plan Process - Oct. 17, 2022
Nursing Facility Placement - Oct. 17, 2022
Provider Postpartum - March 21, 2022
What Providers Need to Know About Pharmacy - March 15, 2024
Managed Care Claims and Prior Authorization Submission: Frequently Asked Questions - Part 2 - May 14, 2024
Panel Management - July 30, 2024
Prompt Payment - Dec. 18, 2024
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 - March 14, 2025
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) - March 15, 2024

Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Fact Sheet

Credentialing Committee - March 25, 2025
Delegated Enrollment/Credentialing - March 25, 2025

Visit the 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

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AHEC Practice Support

For more information on AHEC practice support including the Back Porch Series, visit the AHEC Practice Support page.

Health Plan Resources

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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.