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 Provider Services): 1-800-688-6696 or 919-851-8888
- Automated Voice Response System (HP Enterprise Services): 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 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
- Durham Center ProviderConnect
- Phone Number: 919-560-7100
- Fax Number: 919-560-7377
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E
- Eastpointe LME
- Toll Free Number: 1-800-513-4002
- Fax Number for Behavioral Health: 910-298-7189
- Fax Number for CAP/MR-DD: 910-298-7184
- [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 Electronic Commerce Services): 1-800-688-6696 or 919-851-8888
- Electronic Data Interchange (EDI) (HP Enterprise Services 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): 919-814-0049
- Rate Setting (DMA Financial Operations) –
Hospital, LTC, and Behavioral Health Rate Setting: 919-814-0060
Professional Services Rate Setting: 919-814-0070
- Forms
- Billing, Prior Approval, etc. (HP Enterprise Services 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: 1-800-622-7030
- Children with Special Health Care Needs: 1-800-737-3028
- Mental Health Case Manager: 1-800-753-3224
- Pharmacy Benefit Manager (Medco ): 1-800-466-4115
- Prior Approval: 1-800-672-7897
- Health Insurance Premium Payment Program
- HIV Case Management Services
- Hospital Services (DMA Clinical Policy): 919-855-4260
- HP Enterprise Services (billing issues, covered services, bulletins, electronic commerce, seminars): 1-800-688-6696 or 919-851-8888.
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I
- Independent Assessment for Personal Care Services
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J
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K
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L
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M
- Maternal Support Services (DMA Clinical Policy): 919-855-4320
- Medco (NC Health Choice Pharmacy Benefit Manager): 1-800-466-4115
- Medicaid Bulletins (HP Enterprise Services Provider Services): 1-800-688-6696 or 919-851-8888
- Medicare Crossovers (HP Enterprise Services Provider Services): 1-800-688-6696 or 919-851-8888
- MedSolutions
- Prior Authorization for Radiology and Ultrasound Procedures: 1-888-693-3211
- Fax Number:1-888-693-3210
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N
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O
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P
- Pathways LME
- Phone Number: 704-884-2501
- General Fax Number: 704-884-2513
- Fax Number for CAP/MR-DD: 1-855-728-4329
- 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 Screening and Resident Review (PASRR): 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 Behavioral Health Services
- Prior Authorization for CAP/MR-DD Services
- Crossroads Behavioral Healthcare (Buncombe, Davie, Forsyth, Henderson, Iredell, Madison, Mitchell, Polk, Rockingham, Rutherford, Stokes, Surry, Transylvania, Yadkin, and Yancey counties): 336-835-1000
- The Durham Center (Alamance, Anson, Caswell, Chatham, Durham, Franklin, Granville, Guilford, Halifax, Harnett, Hoke, Lee, Montgomery, Moore, Orange, Person, Randolph, Richmond, Vance, Wake, and Warren counties): 919-560-7100
- Eastpointe LME (Beaufort, Bertie, Bladen, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Cumberland, Currituck, Dare, Duplin, Edgecombe, Gates, Greene, Hertford, Hyde, Johnston, Jones, Lenoir, Martin, Nash, New Hanover, Northampton, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Robeson, Sampson, Scotland, Tyrrell, Washington, Wayne, and Wilson counties): 1-800-513-4002
- Pathways LME (Alexander, Alleghany, Ashe, Avery, Burke, Caldwell, Catawba, Cherokee, Clay, Cleveland, Gaston, Graham, Haywood, Jackson, Lincoln, Macon, McDowell, Mecklenburg, Swain, Watauga, and Wilkes counties):
704-884-2501
- Prior Authorization for High Cost Drugs (ACS Clinical Call Center): 1-866-246-8505
- Prior Authorization for Outpatient Specialized Therapies
- Prior Authorization for Radiology and Ultrasound Procedures (MedSolutions ):
- Toll Free Number: 1-888-693-3211
- Fax Number: 1-888-693-3210
- 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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R
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S
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U
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V
- ValueOptions :
- Toll Free Number: 1-888-510-1150
- Fax Number (Mental Health/Substance Abuse Services): 1-877-339-8753
- Fax Number (Intellectual and Developmental Disability Services): 1-877-339-8754
- Fax Number (Inpatient Services and Psychiatric Residential Treatment Facility Services): 1-877-339-8760
- Fax Number (N.C. Health Choice): 1-877-339-8758
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W-Z
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