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

Claims and Billing

Budget Initiatives

DMA will implement a number of changes in response to legislated budget reductions. Read more about budget initiatives > >

Submitting Claims to Medicaid

Annual Visit Limitation

Prior Approval

Prior approval (PA) may be required for some services, products or procedures to verify documentation of medical necessity. Read more about prior approval > >

The Medicaid Recipient Due Process Rights and Prior Approval Policies and Procedures (PDF, 157 KB) documents the instructions for Medicaid recipient due process rights and prior approval procedures for N.C. Medicaid providers and all agency staff and contractors that perform utilization review functions on behalf of DMA.

Third-Party Insurance

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. Read more about the replacement MMIS > >

Electronic Health Record Incentives

The American Recovery and Reinvestment Act of 2009 External link provides for the promotion of electronic health records (EHR) through incentives. Read more about EHR > >