This information about reimbursement methodologies and acceptable billing practices may help health care providers bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information. More information
1. An important reminder that Medicaid beneficiaries have Value Added Services available through their health plan that can be beneficial in helping patients better adhere to their care plan and contribute to improvements when addressing these Quality Improvement Initiatives.
2. On April 1, 2023, approximately 55,000 children receiving NC Health Choice coverage will move to NC Medicaid For more information
3. NC Medicaid changed the start date for Tailored Plans. The new start date is October 1, 2023. Until October 1, 2023, you will keep getting services the way you do now. For more information
4 Medicaid Standard Plans are required to conduct at least two PIPs annually, which must be approved by the Department of Health Benefits. The State may also mandate PIPs to support statewide priorities. The State has determined the following as the 2022 required PIPs:
To view NC provider Medicaid managed care trending topics following this link.
1. The North Carolina Medical Board (NCMB) allows you to access The Licensure Gateway portal to apply for a North Carolina medical license, complete a license renewal, manage licenses, and update licensee information.
2. Were you successful with getting signed up for the NCDAVE System? All clinicians in NC should register with NCDAVE. Register for NCDAVE today
5 MOC IV NC Maintenance of Certification : The North Carolina AHEC Practice Support Program is an approved Project of the North Carolina Maintenance of Certification (NC MOC) Program, an approved sponsor of the American Board of Medical Specialties’ (ABMS) Multi-specialty Portfolio Program (MSPP). Most ABMS Member Boards recognize this participation as an option to meet Part IV requirements. The National Commission on Certification of Physician Assistants (NCCPA) also accepts NC MOC credit for physician assistants. Through this approval, physicians and physician assistants who work with an NC AHEC Practice Support coach to improve care for patients will meet the requirements of their specialty boards to maintain certification in their specialties.
Effective July 1, 2021, enrollment and eligibility data was added to NCTracks for managed care (MC). The added information will allow authorized users to search the following:
In addition to the changes made in the NCTracks portal, the corresponding 270/271 companion guide (located on the Trading Partner Information Page) has been updated to reflect the additional information. Trading partners and providers are encouraged to review these important updates.
Southern Regional AHEC Practice Support team is committed to helping providers in our region. The SR-AHEC Region consists of the following Counties: Cumberland, Harnett, Hoke, Lee, Montgomery, Moore, Richmond, Robeson, Sampson, and Scotland. We are committed to helping providers meet national standards and ready themselves for valued based care. Health care practices in North Carolina face many challenges. Our team is trained to work with you to transform the way in which care is delivered in your practice. This series includes self-paced online courses designed for medical assistants and other members of your team.
The services offered:
“Medicaid Transformation” The North Carolina Department of Health and Human Services Division of Health Benefits and North Carolina AHEC are offering an evening webinar series to help prepare providers, practice managers, and quality managers for MMC which is going live July 1, 2021. These webinars are hosted by Shannon Dowler, MD, Chief Medical Officer of the NC Division of Health Benefit. The series will feature various subtopics on Medicaid Managed Care on the first Thursday of each month, Advanced Medical Homes on the second Thursday of each month, and clinical quality on the third Thursday of each month through June 2021. Topics will be listed as they become available. LINK
Other resources for Medicaid Managed Care for Providers, Practice Managers and Quality Managers
Southern Regional AHEC Practice Support staff will support community-based efforts for COVID-19. Our staff has begun teleworking and utilizing technology to conduct encounters with clinicians and practice staff.
We remain fully committed to supporting our community of clinicians and practice staff through this virtual outreach. Our practice support coaches will continue to provide services for you during the pandemic.
