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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Managed Care

Darryl Frazier, Chief
Phone, 919-855-4780
Fax. 919-715-5235


Community Care of North Carolina/Carolina ACCESS (CCNC/CA) is the primary care case management health care plan for a majority of Medicaid citizens of this state. The objective of CCNC is to create community health networks to achieve long-term quality, cost, access and utilization objectives.

Managed Care Sections

The Managed Care Section oversees the Managed Care Customer Service Unit and Program Operations.

Managed Care Customer Service Unit

DMA's Managed Care Customer Service Unit provides information to callers regarding Medicaid covered services or resources that are available to help resolve problematic issues and/or navigate the Medicaid health care system. A majority of callers are Medicaid recipients; however, service providers also call for assistance with situations that involve the delivery of care to Medicaid recipients.

The Customer Service (CS) Unit creates, reviews, and analyzes reports used to track program status and performance.

 

Program Operations

Program Operations in conjunction with Customer Service is responsible for the day to day operation of North Carolina's Managed Care programs. Specific responsibilities of the unit include:

  • Planning, Implementation, Development, and Maintenance of Managed Care program initiatives and projects, policies and procedures, research and analysis.
  • Lead/Assist in the continuous development of Community Care of NC/Carolina ACCESS.
  • Oversight and Monitoring of CCNC/CA Managed Care program projects.
  • Retention and Education of CCNC/CA primary care providers.
  • Assist providers in completing the Carolina ACCESS application and agreement.
  • Provide Training and Consulting services to Carolina ACCESS-Community Care of NC participating providers.
  • Ensure/Enforce provider compliance with the Carolina ACCESS Agreement.
  • Investigate/Resolve recipient complaints made against Carolina ACCESS providers.
  • Assist Carolina ACCESS providers in resolving claim denials related to managed care.

 

 

 

State of North Carolina Home Page
May 29, 2013