Frequently Asked Questions and Answers - Medicaid Providers

In addition to the NC Medicaid Provider webpage, Medicaid providers now have a supplemental resource to research their questions and submit inquiries. The NC Medicaid Help Center is an online source of information about Managed Care, COVID-19, Medicaid and behavioral health services, and is also used to view answers to questions from the NC Medicaid Help Center mailbox, webinars and other sources. The NC Medicaid Help Center includes resource documents such as COVID-19 Medicaid Bulletins. To use this tool:

Go to the NC Medicaid Help Center
Type a topic or key words into the search bar; or,
Select a topic from the available list of Categories

FAQs are listed in categories from questions based on popular topics such as COVID-19, telehealth services, health plan enrollment, provider reimbursement, etc. Based on the entry or selection, The Help Center will return all related information. Providers may also select a topic from the Most-Viewed or Top-Rated articles section as available to find answers. The Help Center is continually updated as new information becomes available.

Questions and answers posed during the Medicaid Transformation webinars will be posted to the Medicaid Managed Care Hot Topics Webinar Series page as they become available for each webinar session.

If, after using the NC Medicaid Help Center, the inquiry remains unresolved, use the below table to direct the question appropriately:

Question Type	Resource / Phone Number
Provider Enrollment in Medicaid	NCTracks Call Center at 800-688-6696. To update your information, please log into NCTracks provider portal to verify your information and submit a MCR or contact the NCTracks Call Center. Department Provider Enrollment page
Provider Contracting Inquiries	Health Plans – Contact Info Department Provider Contracting with Health Plans page Department Fact Sheet Reference: Contracting with Health Plans
Provider to PHP Contracting Concerns, or General Complaints	Provider Ombudsman Email: Medicaid.ProviderOmbudsman@dhhs.nc.gov Phone: 866-304-7062
Prior Authorizations	Health Plans – Contact Info Department Fact Sheet Reference: Managed Care Claims and Prior Authorization Submission: What Providers Need to Know - Part 1 Managed Care Claims and Prior Authorization Submission: Frequently Asked Questions - Part 2
Recipient Eligibility, Claims Processing, Billing Questions	Medicaid Direct NCTracks Call Center at 800-688-6696 or log into NCTracks provider portal to update your information, submit a claim, review claims status, request a prior authorization or submit a question. Standard Plan Health Plans – Contact Info Department Fact Sheet Reference: What Providers Need to Know: Part 2 – After Managed Care Launch Panel Management Managed Care Claims and Prior Authorization Submission: What Providers Need to Know - Part 1 Managed Care Claims and Prior Authorization Submission: Frequently Asked Questions - Part 2

In addition to the resources above, providers may find the latest information about NC Medicaid in the Medicaid Bulletin or by subscribing to the NCTracks mailing list.