Practice Support Update Blog

​Medicaid Managed Care: Hardship Advances  ​

Aug 25, 2021 3:00:00 PM / by Practice Support Team

DHHS and PHPs are aware of potentially delayed payments and increased claim denials during the transition period. Providers experiencing claim payment issues should initially work with the PHPs to address claim issues and avoid the need for a hardship advance. 


For more information refer to the Guidance for Providers Experiencing Payment Issues bulletin [].  


Hardship Advances 

MedicaidAs DHHS, PHPs and providers address the various claim processing problems, providers who are at risk of not meeting financial obligations this month as a result of claim processing issues may request a hardship advance to offset the business cost due to pended or denied claims.  


To request a hardship advance, send an email to the Provider Ombudsman at In the body of the email, include: 

  • Financial obligations the provider is unable to meet 
  • Estimated total monetary impact to the provider of unpaid managed care claims 
  • The NPI number of the provider who will receive the advance 
  • A list of the unpaid managed care claims, the associated PHP and the reason the claim has not paid (i.e. denial reason) 
  • Name, telephone number and email address of the provider’s contact person 

DHHS and PHPs will respond to the completed request by contacting the provider to resolve any claim payment issues and sending a hardship agreement, if necessary. Upon resolution of the managed care claim transition issues, DHHS and PHPs will notify providers of the need to submit claims and if advances have been issued, they will be recouped from future payments.  

Thank you for your patience and cooperation as we work to resolve managed care transition claim issues. 

For more information, please see the Medicaid bulletin Expedited Hardship Advances for Managed Care Providers []


Tags: Medicaid Managed Care

  • There are no suggestions because the search field is empty.

Practice Support Services

Health care practices in North Carolina face many challenges. Our team of quality improvement coaches (QICs) have skills and expertise to support you in your transformation efforts.

To learn more about Practice Support Click Here

Apply for practice support services - fill out an application here

Subscribe to Blog Updates

Additional Resources:
Tip Sheets
Lib Guides
Interactive Resource Guides
Digital Library
New call-to-action
Join email list

Connect With Us:

Posts by Topic

See all

In Case You Missed It... Check Out These Recent Posts