Practice Support Update Blog

Extension to NC Medicaid Managed Care Appeals Deadlines

Dec 14, 2021 1:24:58 PM / by Practice Support Team

Provider appeal rights defined in the Standard Plan Contract Section V.D.5 Provider Grievances and Appeals, and the appeal processes outlined in the Prompt Payment Fact Sheet, include deadlines to submit appeals which may vary by Standard Plans, from 30 days to 365 days after the decision giving rise to the right to appeal.  

Medicaid

The Department shared concerns from providers about these deadlines with the Standard Plans. In response, Standard Plans will temporarily extend the following minimum appeal timeframes to support the transition to NC Medicaid Managed Care:

Appeal Submission Date Minimum Appeal Timeframe
Through Jan. 31, 2022 90 calendar days from the decision giving rise to the right to appeal
Feb. 1, 2022 through March 31, 2022 60 calendar days from the decision giving rise to the right to appeal
April 1, 2022 and later

30 calendar days from the decision giving rise to the right to appeal

 

NC DHHS Bulletin for more information

 

Tags: Medicaid Managed Care, NCDHHS

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