To provide some clarity on prior authorization submissions, NCDHHS issued a NC Medicaid Managed Care Provider Update on Friday July 9, 2021 that includes  information about claims submission and prior authorizations under Medicaid managed care.  

Common Billing Error - Taxonomy Codes Missing, Incorrect or Inactive 

On July 7, 2021 NCDHHS posted an updated bulletin highlighting flexibilities for prior authorizations during the first 60 days of the transition to Medicaid Managed Care. 

On July 9, 2021, an addendum to COVID-19 Bulletin #168 was released in SPECIAL BULLETIN COVID-19 #170: Update on Vaccination Counseling Code Reimbursement. Read highlights below. 

This is a friendly reminder that there are only four months left to apply for a final payment of up to $8500 from the NC Medicaid EHR Incentive Program [medicaid.ncdhhs.gov].  

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NCDHHS has recently released two special bulletins outlining temporary provisions related to the extension of COVID-19 temporary provider rates and clinical policies.  Read more about these changes in Special Bulletins 169 and 171.   

It’s hard to believe the Medicaid Managed Care launch is upon us.  The past year and a half we have experienced many challenges to be sure. You can rest assured your Northwest AHEC Practice Support team is here to help you navigate these changes.  Below are some new resources NCDHHS has provided to help you and your practice as they launch Medicaid Managed Care. 

With Medicaid Transformation comes the introduction of new points of contact for beneficiaries, such as the Enrollment Broker and health plans. A long-term goal of NC Medicaid is to provide a single point of contact – one number – for beneficiaries to call for assistance. For now, please try to direct beneficiaries to the appropriate contact using the information provided in this guide. The attached tables provide the various points of contact, key responsibilities, and phone numbers and/or websites beneficiaries can use.  

All Carolina Access Providers who received health equity payments are asked to take 5-10 minutes to complete this survey by July 16, 2021. The survey allows DHHS to monitor and evaluate how these payments were used.