Resources

MEDICAID 101

• PUBLIC CONSULTANT GROUP​
• DIVISION OF MEDICAL ASSISTANCE (DMA)
• DMA MEDICAID AND HEALTH CHOICE BULLETINS

REPORTING PROVIDER CHANGES

• ​NCTRACKS WEBSITE
• NCTRACKS NEWSLETTERS
• NCMMIS PROVIDER CLAIMS AND BILLING ASSIS-TANCE GUIDE
• NORTH CAROLINA MEDICAID AND HEALTH CHOICE CLINICAL COVERAGE POLICY
• AFFORDABLE CARE ACT

BENEFICIARY ELIGIBILITY

NCTRACKS AUTOMATED VOICE RESPONSE SYSTEM (AVRS) 1-800-723-4337
ELECTRONIC DATA INTERCHANGE: 1-800-688-6696

• NCTRACKS SECURE PROVIDER PORTAL
• LOCAL DSS OFFICES

PRIOR APPROVAL

• ​NORTH CAROLINA MEDICAID AND HEALTH CHOICE CLINICAL COVERAGE POLICY 
• NCMMIS PROVIDER CLAIMS AND BILLING ASSISTANCE GUIDE​
• NCTRACKS SECURE PROVIDER PORTAL

​NCTRACKS AUTOMATED VOICE RESPONSE SYSTEM: 1-800-723-4337

• PRIOR APPROVAL PROCESS (DMA)
• NCTRACKS PRIOR APPROVAL FACT SHEET
• PRIOR APPROVAL REQUEST FORMS (NCTRACKS)

CLAIMS SUBMISSION

• CLAIMS SUBMISSION (NCTRACKS)  
• NCMMIS PROVIDER CLAIMS AND BILLING ASSISTANCE GUIDE
• ICD-10 CODES (NCTRACKS)

FRAUD, WASTE AND ABUSE

• PROVIDER SELF-AUDIT PACKETS
• ONLINE FRAUD COMPLAINT FORM

DHHS CUSTOMER SERVICE CENTER: 1-800-662-7030
HEALTH CARE FINANCING
ADMINISTRATION OFFICE OF INSPECTOR GENERAL’S FRAUD LINE: 1- 800 447-8477

MEDICAID
FRAUD, WASTE AND PROGRAM ABUSE TIP-LINE: 1-877-362-8471
STATE AUDITOR’S WASTE LINE: 1-800-730-8477

• ​OMBUDSMEN CONTACT INFORMATION FOR ALL NC

MED AIDE & NURSE AIDE FOR ALL NC

• ADULT CARE HOME MEDICATION AIDE AND NURSE AIDE ONLINE VERIFICATION

​BOARD OF NURSING FOR ALL NC

• NCBON WEBSITE
• NC BOARD OF NURSING ONLINE VERIFICATION
• LIBERTY HEALTHCARE MANAGEMENT
• QIREPORT

PROVIDER REGISTRATION FORMS

• PROVIDER REGISTRATION FOR PCS AGENCY OR FACILITY USE OF QIREPORT
• REQUEST FOR INDEPENDENT ASSESSMENT FOR PERSONAL CARE SERVICES (PCS)

– ATTESTATION OF MEDICAL NEED

• FORMS FOR MEDICAID PERSONAL CARE SERVICES (PCS)