North Carolina Medicaid and Health Choice Provider Training: Brought to you by Public Consulting Group


The keys to being a successful Medicaid or Health Choice provider in North Carolina are just a few clicks – and videos – away.

Regardless of whether you recently passed the North Carolina Medicaid and Health Choice Provider Training course as a newly-enrolling Medicaid provider, or you’re a tenured professional of the Medicaid program, we invite you to explore this set of informational training videos to stay up-to-date on Medicaid policies and procedures. These videos are part of a broader course which is required for all newly enrolling Medicaid providers in North Carolina. Through these, you will have a base understanding of your roles and responsibilities as a Medicaid professional and the resources to turn to for help. Enjoy!

Please feel free to share this site with your colleagues. Also, see our Resources page for additional educational materials.

 

Lesson 1: Medicaid 101

The most successful and compliant providers in North Carolina are the ones who have a base understanding of the Medicaid program and the resources to turn to if they need help.

Lesson 2: Reporting Changes

Providers must report any changes in the management or operations of their practice to CSC within 30 days by completing a Managed Change Request or a Provider Enrollment...

Lesson 3: Beneficiary Eligibility

Prior to rendering services, providers must confirm a beneficiary’s eligibility status for Medicaid or Health Choice for the date services will be provided.

Lesson 4: Covered Services

Providers must adhere to the service stipulations around covered and non-covered services, both of which are outlined in the North Carolina Medicaid and Health...

Lesson 5: Prior Approval

Services that are expensive or may have a history of abuse or over-utilization may require pre-authorization, or prior approval, before administration and reimbursement.

Lesson 6: Claim Submissions

North Carolina Medicaid encourages providers to submit claims on time in order to eliminate a delay between the time when services were provided and when reimbursement...

Lesson 7: Fraud, Waste & Abuse

As a trusted professional of the Medicaid program, it is your duty to report any suspected cases of fraudulent behavior of a fellow provider or Medicaid beneficiary.

NOTICE

These training videos are brought to you by Public Consulting Group, Inc. (PCG), on behalf of the North Carolina Division of Medical Assistance. Under no circumstances will watching the training videos posted on this portal satisfy the training requirement of your Medicaid Provider Enrollment Application. If you have been instructed by CSC to conduct online training, please contact the Public Consulting Group Enrollment Center by calling 1-877-522-1057, select option 1. A PCG representative will help you register for the correct course on our official training site.