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Medicaid Provider Topics A-Z
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D
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F
G
H
I
J
K
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M
N
O
P
Q
R
S
T
U
V
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A
Adult Care Homes
ADA Dental Claim Form - To order call 1-800-947-4746 or go online to
http://www.adacatalog.org
Advance Directives
Ambulance Services
Ambulatory Surgical Center Services
Annual Visit Limits
Automatic Deposits (Electronic Funds Transfer)
Automated Voice Response (AVR) System
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B
Baby Love
Basic Medicaid Billing Guide
Be Smart Family Planning Medicaid Waiver
Behavioral Health Services
Billing
Budget Initiatives
Bulletins
Medicaid General and Special Bulletins
Pharmacy Newsletters
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C
Related Site:
Carolinas Center for Medical Excellence (CCME) Website for Prior Authorization of Outpatient Specialized Therapies
Case Management Services for Adults and Children At-Risk of Abuse, Neglect, or Exploitation
Change in Provider Status
Checkwrite Schedule
Child Service Coordination Program
Chiropractic Services
Claims
Basic Medicaid Billing Guide
Checkwrite Schedule
Electronic Claims
Electronic Funds Transfer
Forms (Claims and Claim Adjustment)
Information about DMA Budget Initiatives Related to Electronic Claims
Related Site:
NC Electronic Claims Submission/Recipient Eligibility Verification Web Tool
Status
Submitting Claims on Paper
Time Limits for Filing Claims
Clinical Coverage Policies and Provider Manuals
Proposed Clinical Coverage Policies
Community Alternatives Program (CAP)
CAP/Choice
CAP for Children (CAP/C)
CAP for Disabled Adults (CAP/DA)
CAP for Mentally Retarded/Developmentally Disabled Individuals (CAP/MR-DD)
Community Care of North Carolina/Carolina ACCESS (CCNC/CA)
Forms
Management Reports
Other Reports
Overview and History of Managed Care in NC
Regional Managed Care Consultant List
Related Site:
CCNC Home Page
(Network Information)
Community Supports
Contacts
Cost Assessments, Report, and Settlements
Related Site: CSC (
NC Tracks Home Page
)
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D
Denied Claims (refer to the
Basic Medicaid Billing Guide
)
Dental and Orthodontic Services
Drug Utilization Review (DUR) Board Meetings
Durable Medical Equipment
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E
Early Intervention Services (through Children’s Developmental Service Agencies)
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT)
Electronic Claims
Information about DMA Budget Initiatives Related to Electronic Claims
Electronic Claims Submission (ECS) Agreement for Groups
Electronic Claims Submission (ECS) Agreement for Individuals
Electronic Commerce Services (refer to the
Basic Medicaid Billing Guide
)
Electronic Funds Transfer
Electronic Funds Transfer (EFT) Authorization Agreement for Automatic Deposit form
Eligibility (Recipient)
Information for the General Public
Information for Providers (refer to the
Basic Medicaid Billing Guide
)
Verifying Eligibility
End-Stage Renal Disease Services
Enhanced Behavioral Health Services (Community Intervention Services)
Related Site:
Enhanced Pharmacy Program Website for information on Drugs that Require Prior Authorization
Enrollment (Provider)
Related Site:
NC Tracks
Explanations of Benefits (EOBs) Codes
Refer to Section 8 of the
Basic Medicaid Billing Guide
Related to NPI and Taxonomy
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F
False Claims Act
Family Planning Medicaid Waiver (Be Smart)
Federally Qualified Health Centers
Fee Schedules
(Reimbursement)
Forms
Fraud and Abuse
Fraud and Abuse Confidential Online Complaint Form
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G
top
H
Health Check
Billing Guide
Policies and Procedures Manual for Health Check Coordinators
Health Departments Services
Hearing Aids
HIPAA (Health Insurance Portability and Accountability Act)
Companion Guides
Electronic Transactions
EOB Code Crosswalk to HIPAA Standard Codes
Privacy Regulations
Submitting Patient Information to the NC Medicaid Program
Trading Partner Agreements
HIV Case Management
Holiday Schedule
Home Health Services
Home Infusion Therapy
Hospice Services
Hospitals Services (Inpatient, Outpatient, Out-of-State)
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I
Independent Practitioner Services
Intermediate Care Facilities for Individuals with Mental Retardation or Developmental Disabilities
Institutional Care
Adult Care Homes
Intermediate Care Facilities for Individuals with Mental Retardation or Developmental Disabilities (ICF/MR-DD)
Nursing Facilities
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J
top
K
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L
Laboratory Services
Legislative Reports
Local Education Agencies
Local Management Entities Utilization Management
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M
Managed Care (
Community Care of North Carolina/Carolina ACCESS (CCNC/CA)
Forms
Management Reports
Other Reports
Overview and History of Managed Care in NC
Regional Managed Care Consultant List
Related Site:
CCNC Home Page
(Network Information)
Medicaid Bulletins
Medicaid General and Special Bulletins
Pharmacy Newsletters
Medicaid Identification Cards
Medicaid Integrity Program (MIP)
Medicaid Management Information System (MMIS) - Replacement
Medical Care Decisions and Advance Directives
Medicare
Related Site:
Medicare
Medicare Crossover Reference Request form
Medicare Part D
Third Party Billing Information (refer to the
Basic Medicaid Billing Guide
)
Related Site: Related Site:
MedSolutions Website for Prior Authorization of High Tech Imaging Procedures and Ultrasounds
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N
Related Site:
NC Administrative Code
Related Site:
NC PASARR Online System
Related Site:
NC Electronic Claims Submission/Recipient Eligibility Verification Web Tool
Related Site:
NC Tracks
(Provider Enrollment, Verification, and Credentialing)
National Provider Identifier (NPI)
EOB Codes for Claim Denials Related to NPI and Taxonomy Codes
NPI and Address Database
Recommended Taxonomy Codes for NPI Mapping
Nursing Facilities
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O
OB/GYN Services
Optical Services and Visual Aids
Orthotics and Prosthetics
Outpatient Behavioral Health Services
Outpatient Pharmacy Services
Enhanced Specialty Drugs List
Medicare Part D
Pharmacy Newsletters
Related Site:
Enhanced Pharmacy Program Website for Information on Drugs that Require Prior Authorization
State Maximum Allowable Cost (SMAC) List
Synagis for RSV
Outpatient Specialized Therapies
Related Site:
Carolinas Center for Medical Excellence (CCME) Website for Information on Prior Authorization
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P
Payment Error Rate Management (PERM)
Personal Care Services
Personal Care Services-Plus
Preadmission Screening and Annual Resident Reviews (PASSAR)
Related Site:
NC PASARR Online System
Pharmacy (Outpatient) Services
Drug Utilization Review (DUR) Board Meetings
Enhanced Specialty Drugs List
Medicare Part D
Pharmacy Newsletters
Related Site:
Enhanced Pharmacy Program Website for Information on Drugs That Require Prior Authorization
State Maximum Allowable Cost (SMAC) List
Synagis for RSV
Physician Services
Physicians Drug Program
Piedmont Cardinal Health Plan (PCHP)
Prior Approval (refer to the
Basic Medicaid Billing Guide
)
Related Site:
Carolinas Center for Medical Excellence (CCME) Website for Prior Authorization of Outpatient Specialized Therapies
Related Site: Related Site:
Enhanced Pharmacy Program Website for Information on Drugs that Require Prior Authorization
Related Site:
MedSolutions Website for Prior Authorization of High Tech Imaging Procedures and Ultrasounds
Related Site:
ValueOptions North Carolina Service Center for Prior Authorization of Behavioral Helath Services
Private Duty Nursing
Program of All Inclusive Care for the Elderly (PACE)
Proposed Clinical Coverage Policies
Provider Enrollment
Related Site:
NC Tracks
top
Q
Quality, Evaluation, and Health Outcomes (QEHO) Initiatives
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R
Radiology Services
Related Site:
MedSolutions Website for Prior Authorization of High Tech Imaging Procedures and Ultrasounds
Rate Setting and Reimbursement
Recipient Eligibility
Information for the General Public
Information for Providers (refer to the
Basic Medicaid Billing Guide
)
Verifying Eligibility
Remittance and Status Report (refer to the
Basic Medicaid Billing Guide
)
Replacement MMIS
Reporting a Change in Provider Status
Resolving Denied Claims (refer to the
Basic Medicaid Billing Guide
)
Rural Health Clinics
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S
State Plan
Synagis for RSV
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T
Tamper-Resistant Prescription Pads
Third Party Insurance
Basic Medicaid Billing Guide
Third Party Insurance Codes
Trading Partner Agreement
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U
top
V
Related Site:
ValueOptions North Carolina Service Center for Prior Authorization of Behavioral Helath Services
Verification of Recipient Eligibility
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W - Z
Waivers
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