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

North Carolina Health Choice (NCHC) Providers

N.C. Health Choice for Children (NCHC) provides free or low-cost health insurance for children and teens from age 6 through the end of the month of their 19th birthday. The benefits covered by NCHC are equivalent to the benefits covered by the Medicaid program with four broad exceptions:

  1. No EPSDT;
  2. No long-term care;
  3. No non-emergency medical transportation; and,
  4. Restricted dental and orthodontic benefits.

Providers submit claims online for processing and payment through NCTracks, www.nctracks.nc.gov. For more information, call CSC at 1-800-688-6696. All claims are expected to be submitted electronically to NCTracks. However, if paper versions of claims are permitted under State policy, they should be mailed to:

     CSC
     P.O. Box 30968
     Raleigh, NC 27622-0968

Any Medicaid-enrolled provider in North Carolina can provide covered services appropriate to their specific licensure and specialization to NCHC Beneficiaries.

For service reliability requirements, coverage criteria, and limitations, refer to the Health Choice Clinical Coverage policies.


Provider Bulletins - NCHC Information

For changes and updates to coverage criteria, billing information, and other program requirements refer to:


Frequently Asked Questions


NCHC Contact Information

  • Provider Customer Service
    For general questions or correspondence, call CSC at 1-800-688-6696, or write:

    CSC
    P.O. Box 300009
    Raleigh, NC 27622-8009
  • Provider Enrollment or Trading Partner Agreements
    Call 1-866-844-1113. Mail supplemental enrollment information to:

    CSC
    Provider EVC Unit
    P.O. Box 3000020
    Raleigh, NC 27622-8020

  • Prior Approval
    Follow this link for a list of which Prior Approvals should be submitted to CSC

    For Medical or Dental prior approval, call 1-800-688-6696
    For Pharmacy prior approval, call 1-866-246-8505

    Mail prior approval requests to:
    CSC
    P.O. Box 31188
    Raleigh, NC 27622-1188
  • Mental Health, Alcohol, and Drug Treatment
    General Information and Questions
    Phone: 1-800-753-3224 or 1-877-339-8758
    Fax: 919-379-9035

  • Children with Special Needs Help Line
    General Information and Questions About Available Services
    1-800-737-3028

  • Pharmacy Benefit Manager: Questions About Prescription Drug Benefits and Claims
    DMA, Claims Analysis: 919-855-4045

 

 

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