Important information independent practices should know about the changes to North Carolina’s Medicaid system
Big changes are coming to Medicaid in North Carolina. Medicaid Managed Care will go-live in all regions on July 1, 2021. The links below provide a quick overview on what's coming, when, and what it will mean for medical practices.
Web pages
- NC Medicaid Help Center - allows providers to search topics, see the most viewed articles and top-ranked articles
- Medicaid Transformation Overview
- Advanced Medical Home (AMH) Overview
- Advanced Medical Home Tier 3 "Glidepath" Payments Update
- Provider questions and comments to DHHS on transformation
- Provider Playbook
- County Playbook
- Specialized Foster Care Plan
- Tailored Care Management
Guidance on Claims Payment Issues
- Managed Care Claims and Prior Authorizations Submission: What Providers Need to Know – Part 1 Fact Sheet
- Managed Care Claims and Prior Authorizations Submission: Frequently Asked Questions – Part 2 Fact Sheet
- Advanced Medical Home (AMH) Overview
- Day One Provider Quick Reference Guide
- Guidance for Providers Experiencing Payment Issues
PDFs
- Medicaid Style Guide with Explanations for Key Terms, Phrases & Abbreviations
- Care Management Strategy Under Managed Care
Web pages
- Other AHEC webinars: Medicaid Managed Care and Advanced Medical Home
PDFs
- Resource list available here
NC DHHS Back Porch Chat Series with NC AHEC & Community Care of North Carolina
This webinar series is designed to support all Medicaid providers, practice managers, quality improvement professionals, care coordinators and other leaders within your practice to help you prepare for the launch of tailored plans in December of 2022. Please tune in for timely Medicaid updates in this monthly series that will build over the next six months to ensure that all of us are ready for launch!
Third Thursdays: Tailored Plan 101: Ready, Set, Launch Webinar Series
Next Webinar: June 16, 2022 from 5:30 p.m. to 6:30 p.m.
- October 1, 2020 - Medicaid Managed Care: recording, transcript, slide deck, Q&A
- October 15, 2020 - Clinical Quality: recording, transcript, slide deck
- November 5, 2020 - Advanced Medical Home: recording, transcript, slide deck
- November 19, 2020 - Women’s Health: recording, transcript, slide deck
- December 3, 2020 - Beneficiary Attribution: recording, transcript, slide deck, Q&A
- December 17, 2020 - Behavioral Health: recording, transcript, slide deck
- January 7, 2021 - Behavioral Health: recording, transcript, slide deck, Q&A
- January 21, 2021 - COVID-19 Vaccine Administration: recording, transcript, slide deck, Q&A
- February 4, 2021 - Tracking Quality Performance, Outcomes, and Expectations: recording, transcript, slide deck, Q&A
- February 18, 2021 - Contracting, Attribution, Provider Directories: recording, transcript, slide deck, Q&A
- March 4, 2021 - Policy Approvals, Process Changes, and Appeals: recording, transcript, slide deck, Q&A
- March 18, 2021 - Panel Management, HOSAR & Health Equity: recording, transcript, slide deck, Q&A
- April 1, 2021 - Value-based Payment/Advanced Payment Models: recording, transcript, slide deck, Q&A
- April 15, 2021 - Pharmacy and Durable Medical Equipment: recording, transcript, slide deck, Q&A
- May 6, 2021 - Behavioral Health Services in Standard Plans: recording, transcript, slide deck, Q&A
- May 20, 2021 - Specialized Therapies, Optical and Hearing Services: recording, transcript, slide deck, Q&A
- June 3, 2021 - Transitions of Care: recording, transcript, slide deck, Q&A
- June 17, 2021 - Hot Topics with Health Plan Chief Medical Officers: recording, slide deck, Q&A
- July 15, 2021 - Managed Care Transition Highs and Lows: recording, slide deck
- August 19, 2021 - Medicaid Hot Topics: recording, slide deck
- September 16, 2021 - Medicaid Hot Topics: recording, slide deck
- October 21, 2021 - Medicaid Hot Topics: recording, slide deck,
- November 18, 2021 - Hot Topic Updates / Behavioral Health Collaborative Codes: recording, transcript, slide deck
- January 20, 2022 - COVID-19 Surge Updates & Hot Topics: recording, slide deck
- February 17, 2022 - Improving with Time – Hot Topics: recording, slide deck
- March 17, 2022 - Telehealth Evaluation & Medicaid Hot Topics: recording, slide deck
- April 21, 2022 - Collaborative Care: recording, slide deck
- June 16, 2022 - Tailored Plan 101: recording, slide deck
- July 21, 2022 - Tailored Plan 101: recording, slide deck
- August 18, 2022 - Tailored Plan 101: recording, slide deck
- September 15, 2022 - Tailored Plan 101: recording, slide deck
- October 20, 2022 - Tailored Plan 101: recording, slide deck
- November 17, 2022 - Tailored Plan 101: recording, slide deck
Please send any questions for subject matter experts to medicaid.covid19@dhhs.nc.gov before 5 p.m. on the Wednesday preceding the webinar.
QI/Population Health (previously Advanced Medical Home) Webinar Series hosted by NC AHEC
Every other month
Next Webinar: July 14, 2022 at 5:30 p.m.
- December 10, 2020 - Series Kickoff: recording, transcript, slide deck
- January 14, 2021 - Tier Support Tool: recording, transcript, slide deck
- February 11, 2021 - AMH Glide Path: recording, transcript, slide deck
- March 11, 2021 - Transition of Care at Managed Care Launch (Crossover): recording, transcript, slide deck
- April 8, 2021 - Transition of Care Part 2: Ongoing Transition of Care Post Launch: recording, transcript, slide deck
- May 13, 2021 - AMH Refresher: recording, transcript, slide deck