Provider Contacts
A
- Accident-Related Issues (DMA Third Party Recovery): 919-647-8100
- ACS Clinical Call Center (Enhanced Pharmacy Program for Drugs that Require Prior Authorization):
1-866-246-8505
- Adult Care Homes/ Personal Care Services Retroactive Requests with DMA (Facility and Community Care): 919-855-4260
- Advance Directives (DMA Clinical Policy): 919-855-4260
- Ambulance Services (DMA Clinical Policy): 919-855-4260
- Ambulatory Surgical Centers (DMA Clinical Policy): 919-855-4260
- Automatic Deposits (Electronic Funds Transfer) (HP Enterprise Services [EDS] Provider Services): 1-800-688-6696 or 919-851-8888
- Automated Voice Response System (HP Enterprise Services [EDS]): 1-800-723-4337
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B
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C
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D
- Denials for Eligibility (DMA Claims Analysis Unit): 919-855-4045
- Denials for Reasons other than Eligibility or Private Insurance (HP Enterprise Services [EDS] Provider Services): 1-800-688-6696 or 919-851-8888
- Dental and Orthodontic Services (DMA Clinical Policy): 919-855-4280
- DMA Sections and Contacts
- Drug Utilization Review (DUR) (DMA Clinical Policy and Programs, Pharmacy and Ancillary Services): 919-855-4300
- Durable Medical Equipment (DMA Clinical Policy): 919-855-4260
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E
- [EDS] HP Enterprise Services (billing issues, covered services, bulletins, electronic commerce, seminars): 1-800-688-6696 or 919-851-8888.
- Electronic Claims Submission (HP Enterprise Services [EDS] Electronic Commerce Services): 1-800-688-6696 or 919-851-8888
- Electronic Data Interchange (EDI) (HP Enterprise Services [EDS] Electronic Commerce Services): 1-800-688-6696 or 919-851-8888
- Electronic Funds Transfer (EFT) (Automatic Deposits) (HP Enterprise Services [EDS] Electronic Commerce Services): 1-800-688-6696 or 919-851-8888
- Eligibility Information: 1-800-723-4337
- Eligibility Information; dates of service over 12 months (DMA Claims Analysis Unit) 919-855-4045
- Enhanced Pharmacy Program (ACS Clinical Call Center for information on drugs that require prior authorization ): 1-866-246-8505
- Enrolling as a Medicaid Provider (including CCNC/CA) (EVC Call Center): 1-866-844-1113
- EVC Call Center (provider enrollment, verification, and credentialing)
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F
- Family Planning Waiver Program - Be Smart (DMA Clinical Policy): 919-855-4260
- Fee Schedules
- Hospital Rate Setting (DMA Financial Operations): 919-855-4200
- Rate Setting (DMA Financial Operations): 919-647-8170
- Forms
- Billing, Prior Approval, etc. (HP Enterprise Services [EDS] Provider Services): 1-800-688-6696 or 919-851-8888
- Enrollment (EVC Call Center): 1-866-844-1113
- Fraud and Abuse (DMA Program Integrity): 919-647-8000
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G
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H
- Health Check/Health Check Program (DMA Managed Care): 919-647-8170
- Health Choice: 1-800- 422- 4658
- Health Choice Mental Health Case Manager: 1-800-753-3224
- Health Insurance Payment Program (DMA Third Party Recovery): 919-647-8100
- Hospital Services (DMA Clinical Policy): 919-855-4260
- HP Enterprise Services [EDS] (billing issues, covered services, bulletins, electronic commerce, seminars): 1-800-688-6696 or 919-851-8888.
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I
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J
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K
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L
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M
- Medicaid Bulletins (HP Enterprise Services [EDS] Provider Services): 1-800-688-6696 or 919-851-8888
- Medicare Crossovers (HP Enterprise Services [EDS] Provider Services): 1-800-688-6696 or 919-851-8888
- MedSolutions: 1-800-575-4594
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N
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P
- Payment Error Rate Management (PERM) (DMA Program Integrity): 919-647-8000
- Physician’s Drug Program (DMA Clinical Policy): 919-855-4300
- Piedmont Cardinal Health Plan (PCHP) Piedmont Provider Relations: 1-800-958-5596
- Pre-Admission Review for Inpatient Psychiatric Admissions or Continued Stay (ValueOptions): 1-888-510-1150
- Pre-Admission Screening and Annual Resident Review (PASARR): 1-800-688-6696 or 919-851-8888
- Prior Approval
- AVR System 1-800-723-4337
- HP Enterprise Services [EDS] Prior Approval Unit 1-800-688-6696 or 919-851-8888
- Prior Authorization for High Cost Drugs (ACS Clinical Call Center): 1-866-246-8505
- Prior Authorization for Outpatient Specialized Therapies
- Private Insurance Update (DMA Third Party Recovery): 919-647-8100
- Procedure Code Pricing: 1-800-723-4337
- Prodigy Diabetes Care, LLC: 1-866-540-4816
- Provider Enrollment (EVC Call Center):
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Q
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R
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S
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T
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U
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V
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W-Z
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