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Claims and Billing

Budget Initiatives

DMA will implement a number of changes in response to legislated budget reductions mandated in SL 2009-451. More about budget initiatives

Submitting Claims to Medicaid

• Claims: Time limits, claims payment, adjustments, and other topics of interest to billers and providers.
• DMA Budget Initiatives Related to Electronic Claims
• List of Exceptions for Electronic Claims (Claims that Must be Submitted on Paper)

Annual Visit Limitation

• Annual Visit Limits for mandatory and optional services.
• Requesting an Exception

Recipient Eligibility Verification

• Recipient Eligibility Verification: What needs to be verified and tools that can be used to verify a recipient's eligibility

Third-Party Insurance

• Third-party Insurance: Third-party insurance codes, forms, and requirements for billing Medicaid.

Medicaid Management Information System (MMIS)

In December 2008, the N.C. Department of Health and Human Services awarded a contract to CSC to develop and implement a replacement Medicaid Management Information System (MMIS) in support of health care administration for multiple DHHS agencies, including DMA. More about the replacement MMIS