As your go-to source for information and advocacy on issues concerning your practice, the NCMS is offering resources and a process to help you make the transition to Medicaid managed care. Below you will find a handy list of state and individual health plan resources.
Medicaid Transformation Resources
- NC Tailored Plans FAQ 022023(pdf)
- NC DHHS Tailored Plan Webpage
- Tailored Care Management Webpage
- LME-MCO Directory
- Tailored Plan Panel Membership 8/26/22
- Tailored Plan Provider Contracting Q&A
- NC AHEC/NC DHHS Webinar Series Webpage
- FACT SHEET: What Providers Need to Know Before Tailored Plan Launch 9/9/22
- 2022 Provider Experience Survey Report
- NC DHHS Medicaid Transformation Webpage
- Provider Ombudsman:
- [email protected]
- 866-304-7062
- Provider Playbook
- Fact Sheets
- Advanced Medical Home Webpage
- FAQ Page
- Fee Schedules
- Trainings
- NCTracks
- Transitions of Care
PDF Downloads
- Day One QRC
- What Providers Need to Know after Go-Live
- Prompt Payment Fact Sheet
- Panel Management for Primary Care Practices Fact Sheet
- Claims and Prior Authorizations Submission Fact Sheet: What Providers Need to Know – Part 1
- Claims and Prior Authorizations Submission Fact Sheet: What Providers Need to Know – Part 2
- Telehealth Program Fact Sheet
- Advance Medical Home Fact Sheet
- Eligibility for Newborns
- Protections for Pregnant Women and Newborns
- Eastern Band of Cherokee Indian (EBCI) Tribal Option Overview
- COVID-19 Member Vaccination Incentive Program Update (12/2021)
- Practice Support and Technical Assistance:
- Quality Improvment_Prenatal Fact Sheet_approved
- Quality Improvment_Diabetes Sheet
- Quality Improvment_Improving Childhood Immunizations-1
Provider Support Number: 888-738-0004
- Provider Manual (PDF)
- Provider Billing Manual (PDF)
- Quick Reference Guide (PDF)
- AmeriHealth NaviNet Portal Page
- AmeriHealth Portal Guide (PDF)
- Provider Newsletter & Updates
- Prior Auth Lookup Tool
- Behavioral Health Toolkit (PDF)
- ACNC Pharmacy Page
- ACNC Clinical Policies Page
- Provider Training Page and Office Hours
- ACNC KNOWN ISSUES TRACKER
Provider Support Number: 833-552-3876
- 2021 Provider Manual (PDF)
- CCH 2021 Provider Billing Manual (PDF)
- Quick Reference Guide (PDF)
- Provider Training Page and Office Hours
- CCH Portal Page
- CCH Provider Updates
- CCH Provider Bulletins/Newsletters
- Prior Auth Lookup Tool
- Behavioral Health Webpage with Toolkits Page
- CCH Pharmacy Page
- CCH Clinical Policies Page
- CCH KNOWN ISSUES TRACKER (KIT)
Provider Support: 844-594-5072
- Provider Manual (PDF)
- Quick Reference Guide (PDF)
- Healthy Blue Availity Portal Page
- Healthy Blue Provider Communications
- Prior Authorization Lookup Tool Page
- Prior Authorization Requirements Page
- Behavioral Health Orientation (PDF)
- Healthy Blue Pharmacy Page
- Healthy Blue Clinical Policy Info Page
- Provider Training Page and Office Hours
- HB KNOWN ISSUES TRACKER
Provider Support: 800-638-3302
Provider Support: 866-799-5318