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

HIV Case Management

DMA Clinical Policy and Programs
Phone Number 919-855-4360
Fax 919-715-2372

HIV case management is a client-focused strategy that:

  1. provides medically necessary services to enhance recipients’ health status and level of functioning, and
  2. promotes cost effectiveness. 

It is designed to empower clients through education, referrals and facilitating access to care, assisting clients to gain the tools needed to be their own advocates and navigate the health care and social services systems to improve health outcomes.  HIV Case management is not intended to be an ongoing service, but rather to be short term, goal-oriented, tailored to meeting the specific immediate needs of the client, with the intention of facilitating the client’s ability to meet his or her own needs.

The goals of HIV case management are:

  1. to improve eligible client’s access to a wide range of appropriate services;
  2. to promote continuity of care by coordinating service delivery arrangements;
  3. to enhance client’s health status and level of functioning; and
  4. to promote efficiency by reducing or containing the overall cost of services.

HIV case management includes the following core components: assessment, care planning, resource development, service coordination, monitoring, reassessment and discharge.

For service requirements, coverage criteria and limitations, refer to:

Medicaid Bulletins

For changes and updates to coverage criteria, billing information, and other program requirements refer to the N.C. Medicaid general and special bulletins.

HIV Case Management Forms