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