nc medicaid providers list

Help you know when to go to the emergency room. A lock icon or https:// means youve safely connected to the official website. Use our maps and filters to help you identify providers that are right for you. Services may not be available at all times, or in all locations, or for all members, and visit limits may apply. 2023 Trillium Resources All Rights Reserved. Support for healthy diet and exercise choices. Healthy Opportunitiesis a new program meant to offer extra support. Provider Support Services: 1-855-250-1539 ePASS is North Carolinas secure self-service website where you can apply for various benefits, view your case details, renew your Medicaid and update your information without having to visit your local DSS. Note that recredentialing does not apply to time-limited enrolled providers, such as out-of-state providers. You can also read Tips for choosing a primary care provider (PCP). CMS hopes to partner with commercial and public payers in the eight pilot states, including state Medicaid programs, to offer models for their members that are aligned to MCP. June 01, 2023. These visits can catch health problems early, so they can be treated. The online Provider Search can help you find a local provider or agency location, walk-in center, crisis center or wellness center. Nearly all new COVID-19 cases are people who are not fully vaccinated. If English is not your first language, free interpreter services are available. Non-emergency transportation includes personal vehicles, taxis, vans, mini-buses, mountain area transports and public transportation. Llame al, Having trouble logging in or registering for an account? Partners Provider Search includes organizations and clinicians participating in both NC Medicaid Direct and Tailored Plans. If you need a printed copy of these directories, one will be provided to you within 5 business days of your request or if you would like to request a Large Print version of any directory, please call 1-888-235-HOPE (4673). Get answers to frequently asked questions for people with Medicaid and Medicare, Caregiver State Government websites value user privacy. An excluded provider is a provider who is barred from participation in Medicare and/or other health care programs, like NC Medicaid, due to program violations. North Carolina Breast and Cervical Cancer Control Program (NC BCCCP) beneficiaries, People living in an institution who get coverage for cost of care, People living in an institution who are receiving coverage for cost of care, Intellectual/developmental disability (I/DD) services. Health Care Option Guide You can get information in another language. The facility does not maintain residents personal funds in a bank account separate from the facilitys operating account. Children, families, pregnant women and single adults may qualify based on income. If NC Medicaid determines that follow-up care is more reasonably available out -of-state, the NC provider shall obtain PA. Search for behavioral health providers and resources. MAABD, MQB-Q, MQB-B, SAAD beneficiary loses eligibility. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs. The affiliated organizational information does not display in these results, including health plan contract affiliation that may be assigned to the affiliated organization but not captured for the individual. Assist providers with Health Information Exchange (HIE) inquires related to NC HealthConnex connectivity compliance and the HIE Hardship Extension process. 2. Espaol (Spanish): Puede obtener materiales gratuitos en letra grande y otras ayudas y servicios auxiliares. Learn about dual health plan benefits, and how theyre designed to help people with Medicaid and Medicare. By responding to this offer, you agree that a representative may contact you. Please register with Availity for direct data entry and online claims submission. Health plans add new providers to their networks, so we update the tool each day. Just ask. Why is it important for me to delete contact persons no longer with my agency/practice? Non-Emergency Medical Transportation (NEMT) Update, Provider Self-Service Quick Reference Guide (PDF), Provider Masters Level Proposed Rates (PDF), NCInCK Information for Health Care Providers (PDF), NCInCK Family Frequently Asked Questions (PDF), NCInCK Provider Frequently Asked Questions (PDF), Member Advisory Committee (MAC) Member Flyer (PDF), Member Advisory Committee (MAC) - LTSS Member Flyer (PDF), Managed Care PHP Member PCP Change Request Form (PDF), Provider Referral Form: LTSS Request for PCS Assessment (PDF), Gastroesophageal Reflux Disease (GERD) and Proton Pump Inhibitors (PPIs) (PDF). P.O. How to get non-emergency transportation. Text4baby can help new and expecting mothers keep themselves and their babies healthy. Our provider search will help you find the best PCP for you and your family. Tailored Plan provider directory by AGENCY, use the Tailored Plan Providers By Agency Directory (PDF). Thank you for your continued assistance in maintaining a comprehensive, integrated and accurate Member-facing Provider Directory. Members that find incorrect information or have questions should email:Questions@partnersbhm.org. If you need an attendant to go with you to your doctors appointment, or if your child (18 years old or younger) is a member of the plan, transportation is also covered for the attendant, parent or guardian. Members who miss three or more trips in a three-month period, or who risk the safety of other passengers or the driver may be suspended from transportation services for up to 30 days. Criminal convictions can deter fraud and abuse. Physical health services include medical doctors and specialists who treat physical health needs. Individuals can also report potential inaccuracies via phone. If so, we want to support their hard work too. If youre affected by a disaster or emergency declaration by the President or a Governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you. Finding a dentist is easy: Select your state from the drop-down menu. The termination or exclusion is in effect until the provider is removed from this list. The provider bills Medicaid for, or the patient is pressured to receive, unnecessary or excessive services, products, or tests. If an annual attestation prompted your review Please sign the annual attestation and return it. The provider will be required to pay the $100NC application fee. Fax: 1-801-994-1082, State Fair Hearing Request You can get information in another language or Braille. Searching by provider in the current tool does not display information about the individual providers affiliated organizations. Find a Provider Search for doctors, hospitals and specialists. The provider directory contains all active Medicaid and NC Health Choice providers, including primary care providers, specialists, hospitals and organizations. So our plan covers care at: Our plan encourages a healthy approach to eating and living. Explain what to expect at each stage of pregnancy. This policy has exclusions, limitations, reduction of benefits, and terms under which the policy may be continued in force or discontinued. Non-emergency and emergency department visits. PDF Adult Care Homes / Homes for the Aged - NCDHHS Box 31364 1-833-870-5588, Monday through Saturday, 7 a.m. to 5 p.m. Search the Provider Directory Now! To help our members be their best, we cover: An online meeting and resource community for pregnant members. UnitedHealthcare Community Plan of North Carolina - Medicaid While NC Medicaid is continuing to learn about the details of MCP and has not yet committed to implementing an aligned model at this time, many of the goals of MCP are reflected in initiatives that NC Medicaid is currently engaged with, such as our workaround advanced medical homes, social determinants of health, streamlining of quality measures across payers, and the State Transformation Collaborative. When you need to see a doctor late at night or cant make it to your doctors office, LiveHealth Online can help. Provider Information Child Care Medicaid Health Care Mental Heath, Developmental Disabilities and Substance Abuse Services NCTracks NCTracks is the new multi-payer Medicaid Management Information System for the NC Department of Health and Human Services (NC DHHS). If you have questions, or would like to join, call us at 1-800-349-1855, TTY 711. Medicaid - Wellcare NC Learn how to create an account here: What is ePASS? Find and compare doctors and other providers near you. To view health plans: Select your county View your choices Choose the best plan for you and your family. That includes working adults, people with disabilities, pregnant women and children. Office of Administrative Hearings (OAH) This plan is not currently available in the ZIP code entered. PDF 1. Where is the Excluded Provider List located on the NC DHHS website? This policy has exclusions, limitations, reductions of benefits, and terms under which the policy may be continued in force or discontinued. Health Benefits (NC Medicaid) You may even need an in-home medical visit to check on how well you are healing. Call 1-888-235-4673 (TTY/TDD Relay NC 711). If the re-credentialing application is not submitted, reminders will be sent at 50 days, 20 days, and 5 days prior to the provider re-credentialing due date. Para informacin en Espaol por favor llame1-888-235-HOPE (4673). Member benefits include: Nothing is more important than the health and well-being of a mother and her baby. You can get free materials in large print and other auxiliary aids and services. Our plan includes classes on diabetes, nutrition and more. Visit our Electronic Claims page, or email NC Provider Relations for more information. Sometimes, you might need a little extra help. Welcome to NCTracks, the multi-payer Medicaid Management Information System for the N.C. Department of Health and Human Services (N.C. DHHS). North Carolina Division of Health Benefits North Carolina Medicaid This is a momentous agreement that will directly improve the health and well-being of 600,000 North Carolinians. Medicaid recipient fraud (fraud by those being served by Medicaid, including fraudulent eligibility and transfer of assets) should be reported to the state Division of Medical Assistance by filing a complaint or by calling 1-800-662-7030. Get supplies, including breast pumps for nursing moms. Find a provider Log in to enroll To search, enter a location and one more search field. Active Provider Recredentialing Due - August - December 2019. Non-emergency transportation services via personal vehicles, taxis, vans, mini-buses, mountain area transports and public transportation are provided through our contracted transportation company ModivCare. Physical healthcare provider directory by NAME, use the Providers By Name Directory(PDF). Rides for routine appointments should be scheduled at least 2 business days in advance by calling between 7:00 a.m. and 6:00 p.m., Monday through Saturday. The member must be ready and at the designated place for pick-up at the time required by the transportation vendor. Provider Referral Form: LTSS Request for PCS Assessment (PDF) Asthma Management Guidelines (PDF) Gastroesophageal Reflux Disease (GERD) and Proton Pump Inhibitors (PPIs) (PDF) Members who are dealing with stress or anxiety can call our 24-Hour Behavioral Health Crisis Line at 1-833-207-4240 to speak with a trained professional. Discount cannot be used online. UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. Some plans may require copayments, deductibles and/or coinsurance for these benefits. You can fill the prescriptions at local pharmacies in the UnitedHealthcare Community Plan network. An official website of the State of North Carolina, Provider Re-credentialing/Re-verification page. Marks of the Blue Cross and Blue Shield Association. Join our Member Advisory Committee or Long-Term Services and Support Member Advisory Committee. You are here: Home Providers Dental Services Dental Services NCTracks supports Dental providers who render services to patients for the N.C. Department of Health and Human Services (DHHS), including prior approval (PA) and claims submission. AmeriHealth Caritas North Carolina Providers Learn how to enroll in a dual health plan. Providers must submit their applications with a valid email address. Check your benefit plan to determine if these services are available. CMS selection of North Carolina as a Medicare pilot state for MCP is a recognition broadly of our innovations and leadership in primary care, care management and addressing health-related social needs, and the goals of MCP align closely with North Carolina Medicaids existing population health priorities. Thats why we provide respite care to give your caregivers a rest. Help you understand your rights and responsibilities, Provide information about Medicaid and Medicaid Managed Care, Answer your questions about enrolling with or disenrolling from a health plan, Help you understand a notice you have received, Refer you to other agencies that may be able to assist you with your health care needs, Help to resolve issues you are having with your health care provider or health plan, Be an advocate for members dealing with an issue or a complaint affecting access to health care, Provide information to assist you with your appeal, grievance, mediation or state fair hearing, Connect you to legal help if you need it to help resolve a problem with your health care needs. Each text contains health and safety tips for topics like: So you and your baby can make a great start on life. Data displayed in the tool will be refreshed daily, at midnight, to reflect completed changes from the previous day. Report Medicaid provider fraud or patient abuseto the Attorney Generals Medicaid Investigations Division at (919) 881-2320. If you were checking it for your own knowledge No action is needed. Supported plans include UnitedHealthcare Dual Complete RP (Regional PPO SNP) R1548-001 and UnitedHealthcare Dual Complete (HMO SNP) H5253-041. North Carolina Division of Health Benefits North Carolina Medicaid Preferred Drug List (PDL) Effective DATE: April 1, 2023 Revised 7.1.2023 for addition of Dexcom G7 Providers with questions about the NCTracks online enrollment application can contact the CSRA Call Center at 800-688-6696; 919-851-4014 (fax), or NCTracksprovider@nctracks.com. Application receipts will be acknowledged by email or by mail. Some benefits will be better; the rest will stay the same. Please email Info@TrilliumNC.org with any corrections. This plan pays for all expenses related to a hospital stay, so you can rest and heal. Earn rewards for going to visits throughout your pregnancy and babys first 15 months of life. Additionally, providers will find links to Provider Announcements, User Guides and Frequently Asked Questions. information in the online or paper directories. You can also go to ncmedicaidplans.gov. read on Getting Started With NCTracks, This section includes User Guides and Fact Sheets designed to help N.C. DHHS providers understand how to use NCTracks, as well as information about Provider Training. Report Medicaid provider fraud or patient abuse to the Attorney Generals Medicaid Investigations Division at (919) 881-2320. Enrollment Providers with questions about the NCTracks online enrollment application can contact the CSRA Call Center at 800-688-6696; 919-851-4014 (fax), or NCTracksprovider@nctracks.com. UnitedHealthcare Connected (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees. PDL September 1 2019. Follow these easy steps to begin using the new system. The NC Medicaid Ombudsman is an independently operated, nonprofit organization whose only job is to ensure that individuals and families who receive North Carolina Medicaid and NC Health Choice get access to the care that they need. For full list of Walgreens brand health and wellness products, please visit www.walgreens.com/Smartsavings. And your doctor can see how your health is progressing. Including: Visit NC medicaidplans dot gov for more information. Although the Medicare portion of the model will begin in 2024, other payers, including Medicaid agencies, have additional flexibility on if, and when, to launch an aligned approach. Fraud by Medicaidrecipients (fraud by those being served by Medicaid) such as fraudulent eligibility or transfer of assetsshould be reported to the North Carolina Division of Health Benefits (at 1-800-662-7030 or online HERE) or to your Local CountyDepartment of Social Services. Medicaid expansion will be transformative for access to health care in rural areas, for better . NC DHHS: Providers Making Care Primary Model Provider Update Limitations, copays and restrictions may apply. It is a short training and a certificate is provided after it is completed. A lock icon or https:// means youve safely connected to the official website. North Carolina provider for follow-up care. Refreshments or meals are served, and free transportation is available. All recommended prenatal clinical visits and tests are covered by our plan. The provider claims to provide services, products, or tests for free.

The public version of the Medicaid and NC Health Choice Provider and Health Plan Lookup Tool is now available. Find a Doctor NC law requires that providers pay a $100 fee for Medicaid recredentialing. NC DHHS: LME/MCO Directory **Only sites that are already active in your contract are able to be posted to the Provider Directory. CMS is offering this model for qualified Medicare providers in North Carolina beginning in July 2024. 844-594-5076 (TTY 711) 24 hours a day, seven days a week. Get a tested, safe, and effective vaccine to protect yourself and others against hospitalization and death.Find a vaccine location near you. STATE AND FISCAL AGENT STAFF - Click on the Operations tab above to enter the Operations Portal and . WellCare of North Carolinapartners with providers to develop and deliver high-quality, cost-effective health care solutions. Find My Plan; 2023 Medicare Basics; 2023 Medication Therapy Management; Video Library; Member Login; Prescription Drug Plans. You can use the NC Medicaid Provider and Health Plan Lookup Tool to find a primary care provider (PCP). Find out more in the flyers below: UnitedHealthcare Community Plan You can find an agency or an individual clinician. Please check the NC Medicaid Provider and Health Plan Lookup Tool again later. We have the Medicaid services and extras that can make a real difference in your life. Medicaid.ProviderOmbudsman@dhhs.nc.gov, or received through the Provider Ombudsman line at 919-527-6666. Out-of-state Medicaid providers are reimbursed according to the North Carolina Medicaid State Plan Amendments 4.19-A and 4.19-B. We have licensed clinicians available to speak with you and to connect you to the support you need to feel better. NC Medicaid Direct provider directory by NAME, use the NC Medicaid Direct Providers By Name Directory(PDF). Provider Central - Alliance Health When a beneficiary is terminated from a Medicaid program and their income is in the QI1/MQB-E range, take the following action: a. What does it take to qualify for a dual health plan? Healthy Blue is a Medicaid plan offered by Blue Cross and Blue Shield of North Carolina. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) Your Copays If Your Child has NC Health Choice*, Brand prescriptions when generic is not available. You can update your information online with ePASS. A lock icon or https:// means youve safely connected to the official website. PDL 2017 2018 2Final Posting August 1 2018. Greensboro, NC 27047, 300 Saint Pauls Road For example, if the legal name begins with The or A, the name entered must begin the same. Visit the Supplier Directory More resources Virtual visits conducted by telephone or video chat with a doctor are not an insurance product, health care provider or a health plan. Our plan does not limit the number the number of times you can see your PCP. The authenticated portal will be available to beneficiaries beginning March 1, 2021. Until October 1, 2023, you will keep getting services the way you do now. For costs and complete details of the coverage, call or write your insurance agent or the company, whichever is applicable. These services may be covered byUnitedHealthcare Community Plan of North Carolina. More information can be found here: medicaid.ncdhhs.gov/renew. Tailored Plans will start October 1, 2023. The resident has bruises, welts, lacerations, broken bones or burns. The member must call the number provided for trip requests to cancel scheduled transportation at least 24 hours in advance. Unless otherwise required, benefits are available only when services are delivered through a Designated Virtual Network Provider. Provider information displayed in the online directory is sourced from the NCTracks provider records and supplemented with health plan contract data. SimpliFed provides free virtual breastfeeding and baby feeding support to UnitedHealthcare Community Plan of North Carolina members, starting in pregnancy. Answer a few quick questions to see what type of plan may be a good fit for you. View the benefits below to see all that it offers. Welcome to NCTracks, the multi-payer Medicaid Management Information System for the N.C. Department of Health and Human Services (N.C. DHHS). PDL 2017 2018 2Final Posting October 29 2018. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. We investigate the commingling of funds of both Medicaid recipients and non-Medicaid residents in facilities that receive Medicaid funds. Physical healthcare provider directory by AGENCY, use the Providers By Agency Directory(PDF). Find Healthcare Providers: Compare Care Near You | Medicare UnitedHealthcare Community Plan of North Carolina Homepage Managed Care Provider Directory . UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call1-888-638-6613TTY 711, or use your preferred relay service. Who can make changes to my directory information? 2021Blue Cross and Blue Shield of North Carolina, Stay informed - activate your online account, Blue Cross and Blue Shield of North Carolina (Blue Cross NC). Frequently asked questions If you are unable to view PDFs, please download Adobe Reader. For more information or to book an appointment, text UHCNC4MILK to 888-458-1364, visit www.simplifed.com/united-nc, or call 844-799-0538. Find out what's new Looking for medical supplies and equipment? every Monday through Friday except State Holidays or visit their website at www.ncmedicaidombudsman.org for more information. View Drug List Find medications covered by this plan. NC HealthChoice members are not eligible to receive non-emergency transportation services. For members who dont have a doctor or whose doctor is not in our network, we can help find a new one close by. WellCare of North Carolina; Member Login; Medicare. Non-emergency: UnitedHealthcare Community Plan of North Carolina can arrange and pay for your transportation to help you get to and from your appointments for Medicaid-covered care. Our plan covers: Well help you get the information needed to improve your health or be at your best. Visit or call your local DSS to update your address and contact information. To learn more, view our full privacy policy. Transportation to and from doctor appointments. The directory is one of the first, and probably the most important, gateways in a persons healthcare journey. Sometimes you might need a little help understanding your health care options. The ending balance in the facilitys ledger showing the residents personal spending does not match the ending balance in the bank statement for the residents personal funds bank account. Individual & Family ACA Marketplace Plans Disclaimer, UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan), UnitedHealthcare Connected (Medicare-Medicaid Plan), UnitedHealthcare Connected for One Care (Medicare-Medicaid Plan), UnitedHealthcare Connected general benefit disclaimer, UnitedHealthcare Senior Care Options (HMO SNP) Plan, Medicare dual eligible special needs plans, medicaid.ncdhhs.gov/nc-health-choice-move-medicaid, Healthy Opportunities Pilot (HOP) Program Member Rights and Responsibilities, provider_directory_invalid_issues@uhc.com, Non-Discrimination Language Assistance Notices, Brand prescriptions when generic is available, Community-Based Doula Programs ($1,200 value), Community baby showers with gifts, resources, and education, Smartphone with free monthly unlimited data, minutes, and texts, Healthy Weight and Your Child wellness program ($880 value), Fresh fruits and vegetables for six months ($240 value), WW (formerly known as Weight Watchers) ($160 value), Up to $75 in rewards to complete wellness activities, Fresh, nutritious meals delivered to your home after discharge from hospital for 14 days, Get up to $160 for GED exam voucher and materials, $25.00 gift card for students grades 9-12 who obtain a 3.5 GPA or higher, Hypoallergenic mattress cover and pillowcase ($150 value), Rides to job interviews and other employment-related activities, $100 yearly for vitamins, massage and acupuncture, Mobile app that offers access to on-demand help for stress, anxiety, and depression at no cost, 24/7 access to live virtual visits with a doctor, Get the answers, treatment and follow-up care you need - at no cost to you, To download the app, search for UHC Doctor Chat on the App Store or Google Play, or visit. Find a Dentist in State | InsureKidsNow.gov If you find any wrong or out of date information on our pages, we want to know. If CMS hasnt provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration. When you have questions about your health, you can call a nurse 24 hours a day, 7 days a week. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program. Medicare is a . After surgery or a serious illness, you may need extra help with day-to-day tasks like cleaning, cooking or dressing. For Providers - Sandhills Center Secure websites use HTTPS certificates. Here are some resources for people with Medicaid and Medicare. . Depending on the search conducted, the results are expected to display the following applicable information for individual and/or organization providers: For organizations, the results will also display a list of individual affiliated providers and include the specialties of those affiliated providers in the Providers Specialty information. Partners Health Management Office 901 South New Hope Road Gastonia, NC 28054 Phone: 704-884-2501 Fax: 704-884-2713 Crisis Line: 833-353-2093 Counties Served: Burke, Cabarrus, Catawba, Cleveland, Davie, Forsyth, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union, Yadkin Sandhills Center Office 1120 Seven Lakes Drive West End, NC 27376 Suite 110 Our Provider Directory is an important resource for our members and recipients, along with network and referral management. Tailored plan members can search for a Physical Health Provider near them. The provider will no longer appear on the list. The . NCTracks Provider Enrollmentprovides the online application and a checklist for provider qualifications and requirements. You can get additional information on our Non-Emergency Medical Transportation policy by calling Member Services at 1-800-349-1855, TTY 711. Our Provider Directory is an important resource for our members and recipients, along with network and referral management. Search the Provider Directory; Report an Incident; Request a Letter of Support; Did we miss something? Then anything we write to you will only be in that language or format. NC Medicaid Provider webpage: Access to Medicaid Bulletin articles and Provider Enrollment information COVID-19 Flexibilities to End Effective May 11, 2023, the clinical policy flexibilities that were instituted as part of the federal Public Health Emergency will end.

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