11/01/2022 Update to Secure Provider Portal
Carolina Complete Health values the relationships we have with our provider partners and works to ensure that doing business with us is easy and straightforward. A key component of meeting provider needs is our secure Provider Portal, which enables providers to conduct business with Carolina Complete Health from the convenience of their desktops seamlessly and in real time.
We are pleased to announce effective of 11/01/2022 the integration of an exciting new tool, InterQual Connect™ in our Secure Provider Portal. Adding features that will simplify the provider experience and offers several new capabilities.
We believe the enhancements to our Provider Portal will create a more user-friendly experience and enhance your ease of doing business with Carolina Complete Health. We hope you will take a moment to explore them.
Please contact Provider Services at 1-833-552-3876 with any questions you may have.
The NC Incident Response Improvement System (IRIS) is now operational for all users. IRIS is a web based incident reporting system for reporting and documenting responses to Level II and III incidents involving consumers receiving mental health, developmental disabilities and/or substance abuse services. Please enter all paper incident reports (faxed or not faxed) into the system. If you receive an error message, please send a screenshot of the error message to QOC_CIR@carolinacompletehealth.com for follow-up.
National Health Center Week (August 7 – 13) is an annual celebration with the goal of raising awareness about the mission and accomplishments of America’s health centers over the past five decades.
Carolina Complete Health Network is a proud partner of the North Carolina Community Health Center Association, whose mission is to promote and support patient-governed community health care organizations and the populations they serve.
Join us in saying thank you to Health Centers around the state; "The Chemistry for Strong Communities"
The new, and more easily accessible, National Suicide Prevention Hotline, launched Saturday, July 16, 2022. This 988 number replaces a longer 1-800 number tied to the Suicide Prevention Lifeline.
Overall calls to the Suicide Hotline show how much the 988 hotline is needed:
So far in 2022, over 20,000 people have called.
The North Carolina Department of Health and Human Services Division of Health Benefits and North Carolina AHEC, in conjunction with the five Medicaid managed care health plans, will host the 2nd Annual Virtual Statewide Quality Forum on August 11, 2022 from 12:30-1:30 p.m. to help providers, practice managers, and quality managers succeed with Medicaid Managed Care quality initiatives.This information session will cover the following topics:
Medicaid Managed Care Webinar Series: Quality & Population Health
Provider Spotlight: Dr. Bret Nicks, an emergency medicine physician in Winston Salem and part of CCHN's Emergency Medicine Policy Workgroup has accomplished an amazing feat: publishing a book! Dr. Nicks' book, titled "Standing Naked in the Rain: The Story of a Good Dog", is a humorous, but thought-provoking collection of short stories that celebrate the life lessons our 4-legged family member teach us. Congratulations Dr. Nicks on your publication!
Sharing from NC DHHS:
Advanced Medical Home Payments
The temporary COVID-19 rates in effect in December 2021 for Carolina Access payments under NC Medicaid and Advanced Medical Home payments under managed care will be end-dated on Dec. 31, 2021.
Effective Jan. 1, 2022, reimbursement of the following Medical Home Fees to Carolina Access and AMH practices shall be revised as listed below:
Carolina Complete Health Network is pleased to announce a grant program to help improve equity and health care delivery for Medicaid recipients and foster grass-roots innovation.
Funds are intended to encourage and amplify the innovative efforts of independent physicians and clinicians to improve health or health equity.
Who should apply?
We encourage collaboration with other practices and community partners. Applicants must be participating in Medicaid with Carolina Complete Health.
What is the award?
Up to 10 applicants will be awarded in amounts ranging from $20,000 to $175,000 for 12 months of funding. Projects should be clinical in nature with the aim to improve healthcare delivery or health equity while lowering costs or remaining cost neutral.
What is the timeline?
Congress has passed the Dr. Lorna Breen Health Care Provider Protection Act to improve the mental health and well-being of healthcare workers. Under the bill, HHS must award grants for training health profession students, residents and healthcare professionals to reduce and prevent suicide, burnout, mental health conditions and substance use disorders, according to the Dr. Lorna Breen Heroes' Foundation. The grants are for hospitals, medical professional associations and other healthcare entities.
Carolina Complete Health is pleased to be able to offer Youth and Adult Mental Health First Aid at no cost! Please see our communication bulletin for more information
In the News: Native American tribes reach landmark opioid deal with Johnson & Johnson
"Hundreds of Native American tribes, devastated disproportionally in the opioid epidemic, tentatively agreed to settle with the country’s three major drug distributors and Johnson & Johnson for $665 million... The funds would be directed to addiction treatment and prevention programs...."
Read more from the Washington Post
January 1, 2022
Beginning February 1, 2022, the following changes will be made to Outpatient Pharmacy Clinical Coverage Criteria and the accompanying prior authorization request forms:
The Centers for Disease Control and Prevention (CDC) National Center for Health Statistics (NCHS) have updated the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code set with 11 new diagnosis codes describing social determinants of health (SDOH). The new Z codes were created to provide additional information regarding SDOH data such as housing, food insecurity, or transportation.
Carolina Complete Health has developed helpful guide with coding tips:
What are Z Codes?
Sharing from NC DHHS
December 6, 2021
Provider appeal rights defined in the Standard Plan Contract Section V.D.5 Provider Grievances and Appeals, and the appeal processes outlined in the Prompt Payment Fact Sheet (PDF), include deadlines to submit appeals which may vary by Standard Plans, from 30 days to 365 days after the decision giving rise to the right to appeal.
The Department shared concerns from providers about these deadlines with the Standard Plans. In response, Standard Plans will temporarily extend the following minimum appeal timeframes to support the transition to NC Medicaid Managed Care:
For more information, see Extension to NC Medicaid Managed Care Appeals Deadlines.
Minimum Appeal Times
|Appeal Submission Date||Minimum Appeal Timeframe|
|Through Jan. 31, 2022||
90 calendar days from the decision giving rise to the right to appeal
|Feb. 1, 2022 through March 31, 2022||
60 calendar days from the decision giving rise to the right to appeal
|April 1, 2022 and later||
30 calendar days from the decision giving rise to the right to appeal
Physicians are significantly more likely to die by suicide than the general population, and an estimated 300 physicians die by suicide in the United States every year. The COVID-19 pandemic has exacerbated the stress, burnout, and fatigue already felt by many physicians, providers, and other healthcare professionals balancing the duty of caring for patients with concerns for their own health and wellbeing. Despite these challenges, many do not seek treatment or support for fear of stigma or professional repercussions.
This training provides specific Suicide Safer Care techniques to help support your primary care providers and team members through systematic and organizational approaches to address suicide risk and prevent deaths by suicide among employees. Join this webinar to learn about the scope of the crisis and how organizations can better support staff through effective suicide prevention and postvention strategies during and beyond the COVID-19 pandemic
Medicaid Managed Care WEBINAR SERIES: Quality & Population Health, December 9 | 5:30-6:30 p.m.
The next webinar in the Quality & Population Health Webinar series, formerly the Advanced Medical Home (AMH) Webinar series, will focus on Advanced Medical Homes: Incentives Plan. This webinar series is designed to support clinicians, practice managers, quality improvement professionals, care managers, and CINs.
National Handwashing Awareness Week is celebrated during the first full week of December. The purpose of this observance is to educate people on the importance of good hand hygiene and the proper techniques.
As important as handwashing has always been, it’s especially crucial now. Remind your patients that washing their hands regularly can help prevent the spread of respiratory viruses, including coronavirus. But it’s important to make sure they’re washing correctly. A quick rinse isn’t enough to kill germs.
The Centers for Disease Control and Prevention suggests remembering five easy steps: Wet, lather, scrub, rinse, dry.
Handwashing is an easy and effective way to protect yourself and others from germs and viruses. Even though it’s simple, many people get complacent and end up skipping handwashing or washing too quickly. By taking the time to educate your patients on how to go through the five steps you can protect yourself, them, and others from illnesses like COVID-19.
Wednesday, December 1, 1:00-2:00 p.m. ET
In this webinar, participants will learn how to identify and refer individuals with prediabetes to CDC-recognized lifestyle change programs. Participants will also learn how a quality clinical, or community referral can help people with prediabetes engage in a diabetes prevention program.
Thursday, November 18, 2021
5:30 PM - 6:30 PM
Please join NC Medicaid Chief Medical Officer (CMO) Dr. Shannon Dowler and Chief of Quality Kelly Crosbie, along with all the NC Medicaid Managed Care Plan CMOs and Behavioral Health (BH) Directors, for the November Back Porch Chat on Thursday, November 18 from 5:30 p.m. - 6:30 p.m. In addition to timely hot topic updates, this webinar will focus on Behavioral Health Collaborative Care Codes and how we can support practices ability to help us achieve the goal of integrated physical and behavioral healthcare for Medicaid beneficiaries in NC. The Managed Care Plan BH Directors will be speaking to key aspects of successfully using BH collaborative care codes and we will be joined from colleagues in practice to share how they are being used in primary care including best practice, lessons learned, specific use cases/scenarios and more! Have a question you would like addressed during the webinar? Please access this link to enter your questions to be sure they are asked and answered on Thursday night! The link will become inactive on Monday, November 15th
October 21, 2021
Sharing from NC Medicaid:
There is now reimbursement available for NC Medicaid-enrolled providers to conduct telephone outreach to unvaccinated beneficiaries.
Effective Oct. 22, 2021, NC Medicaid-enrolled providers can bill code 99401 with HM modifier for telephone outreach to unvaccinated Medicaid beneficiaries. The goal of the outreach is to educate the beneficiaries on the vaccine and assist them in scheduling an appointment, ideally in the office where the outreach is originated.
Read Special Bulletin COVID-19 #192 for more information, a script, as well as billing specifications.
Healthy Opportunity Pilots: Impacts to Advanced Medical Homes/Integrated Care for Kids
Thursday, Oct. 14 | 5:30-6:30 p.m.
This webinar will focus on Integrated Care for Kids (InCK) & Healthy Opportunities (HO) Pilots. This webinar series is designed to support providers, practice managers, quality improvement professionals, care managers, and clinically integrated networks (CINs).
October 13, 2021
Carolina Complete Health is aware of a claims pricing issue with Durable Medical Equipment (DME). We are updating our methodology on how we pay claims for DME to align with state requirements. The new methodology for paying DME claims should be in effect on 10/10/21. Any claims processed before 10/10/21 will be adjusted according to the following guidelines.
For more information, please view our special bulletin that was distributed to DME providers on October 13, 2021
When: Friday October 15, 9AM to 2PM
Where: Martin Street Baptist Church, 1001 E Martin St., Raleigh, NC
This eventis open to everyone: stop by from 9AM-2PM for free over-the-counter products including cold, caough, flu medicine, pain relief, vitatmins, children's medications etc. Read more information and request specific medications online.
October 6, 2021
Every year from October 6 – 12, we celebrate PA Week, which recognizes the PA profession and its contributions to the nation’s health. This #PAweek, CCHN is honoring all PAs do for their patients and their communities and all the ways they add value to healthcare!
This year, the NC Academy of Physician Assistants named H. Truett Smith, MPAS, PA-C, DFAAPA, the 2021 NCAPA PA of the Year! Congratulations, Truett! To read more about Truett and his incredible contributions to North Carolina, visit the NCAPA Blog
Sharing on behalf of the US Department of Health and Human Services:
The Biden-Harris Administration announced today that the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is making $25.5 billion in new funding available for health care providers affected by the COVID-19 pandemic. This funding includes $8.5 billion in American Rescue Plan (ARP) resources for providers who serve rural Medicaid, Children's Health Insurance Program (CHIP), or Medicare patients, and an additional $17 billion for Provider Relief Fund (PRF) Phase 4 for a broad range of providers who can document revenue loss and expenses associated with the pandemic.
More information about eligibility requirements, the documents and information providers will need to complete their application, and the application process for PRF Phase 4 and ARP Rural payments is available through HRSA.
Beginning Thursday September 23rd, Carolina Complete Health will revise the medical claims payment schedule to run weekly on Monday and Thursday. Previously the payment schedule was weekly on Tuesday and Friday.
At the end of May 2021, members of the North Carolina Medical Society were surveyed on the mission and activities of the provider-led entity at the heart of the state’s Medicaid transformation: the Carolina Complete Health managed care plan and its partial owner and partner, Carolina Complete Health Network. The results from this survey suggested our mission, who leads us, and what we do are important to physicians and clinicians. Read the executive summary of the Network Consult survey in full for more details (PDF).
The Council of Residency Directors in Emergency Medicine (CORD), in collaboration with AAEM, ACEP, ACOEP, EMRA, RSA, RSO, and SAEM have come together to annually dedicate September 17th as National Physician Suicide Awareness (NPSA) Day. Read their Zero Vision Statement
In a recent national survey of COVID-19 Caregivers, half of all respondents reported at least one symptom of burnout. Burnout was highest in nurses at 56%. More than one-third of all respondents noted high levels of self-reported anxiety or depression. Nearly a quarter of physician respondents noted they were likely to leave practice within the next two years. Read the executive summary in full for more details (PDF)
Carolina Complete Health Network is committed to supporting the well-being of our network providers, physicians, clinicians, and their staff. As a small token of our immense gratitude, we are offering Resiliency Workshops to network providers and organizations.
In a 2019 Nursing Outlook study, The Community Resiliency Model ® demonstrated improved well-being, resiliency, secondary traumatic stress, and physical symptoms among nurses. Participants reported using CRM techniques for self-stabilization during stressful work events. Read the full article.
Please visit our Resiliency Corner to request more information
Additional Resources for Support
The Division of Health Benefits and North Carolina AHEC, in partnership with the five Medicaid managed care health plans, will host a Virtual Quality Forum to kick off our three Statewide Medicaid Quality Improvement Initiatives on October 12th from 12:00pm to 1:30pm.
This informative session will cover:
We look forward to kicking off this important work with you!
COVID-19 vaccines are available to everyone 12 and older. For more information visit NC DHHS COVID-19 Response page
Nearly all new COVID-19 cases are people who are not fully vaccinated. Get a tested, safe and effective vaccine to protect yourself and others against hospitalization and death. Find a vaccine location near you.
Healthy NC, an initiative of the North Carolina Medical Society, is pleased to present the Lifestyle Medicine Summit in conjuction with the CPP Annual Meeting.
September 24-25, 2021 (Virtual Meeting)
This exciting virtual Summit will provide an introduction to Healthy NC and build knowledge and awareness around Lifestyle Medicine as a branch of medicine that addresses research, prevention, treatment, and reversal of diseases caused by lifestyle factors.
The Southern Regional AHEC designates this live activity for a maximum of 9.75 AMA PRA Category 1 Credit(s)™.
What: Claims support office hours for providers
When: Tues and Thurs / every 2nd and 3rd week of each month / 4 – 5 pm
Duration: For 8 months starting August 19, 2021
Provider must submit email for link to Zoom meeting to NCCH_Claims_NetworkOperations@carolinacompletehealth.com
Providers can submit questions in advance to NCCH_Claims_NetworkOperations@carolinacompletehealth.com
In a recent national survey of COVID-19 Caregivers, half of all respondents reported at least one symptom of burnout. Burnout was highest in nurses at 56%. More than one-third of all respondents noted high levels of self-reported anxiety or depression. Nearly a quarter of physician respondents noted they were likely to leave practice within the next two years.
Carolina Complete Health Network cares deeply about the well-being our network providers, physicians, clinicians, and their staff. To support you, we are offering Resiliency Workshops to all practices and organizations in our network. Using concepts and skills from the Community Resiliency Model, workshops will support your staff in recognizing the physical symptoms of stress and regulate their nervous system.
In a 2019 Nursing Outlook study, The Community Resiliency Model ® demonstrated improved well-being, resiliency, secondary traumatic stress, and physical symptoms among nurses. Participants reported using CRM techniques for self-stabilization during stressful work events. Read the full article.
If you are interested, please contact Jesse Hardin, Head of Stakeholder Excellence and Certified Community Resiliency Model Trainer: email@example.com
Additional Resources for Support
CARE TALKS provide educational resources to Carolina Complete Health (CCH) providers, employees, and members to enhance cultural awareness. CARE TALKS focus on providing resources and education so as a community we can value and understand health disparities, health equity, social determinants of health (SDOH) and culturally related health care differences, as well as increase awareness to how those components impact barriers to care.
This month's CARE TALKS topic is National Immunization Awareness Month (NIAM)
National Immunization Awareness Month (NIAM) is an annual observance held in August to highlight the importance of vaccination for people of all ages.
During the month of August take the time to talk to your patients/parents about:
Missed vaccines and assess vaccination status at every visit.
The immunization schedule is carefully designed to provide protection early, before children are exposed to potentially serious diseases. By ensuring your members/patients are vaccinated, you’ll be protecting them from 16 serious diseases.
Be a champion of vaccination for your practice by ensuring all staff share a consistent message with them and with parents about the importance of childhood vaccines.
While most parents will vaccinate their child when you make an effective recommendation, some parents are looking for reassurance from you that vaccines are safe and effective for their child. Taking the time to listen and understand parents’ concerns can help you save time and build trust.
It may be helpful to educate patients/parents about the safety systems that the United States has in place to monitor vaccines before and after they are licensed. Share pamphlets or flyers to reinforce the information you provide about the safety of recommended vaccines.
Carolina Complete Health issued the first set of medical home fee and care management capitation payments to providers on Saturday, July 24, 2021. For providers who have not yet signed up for EFT, paper checks were sent via FedEx to providers with street addresses and via first class mail to providers with PO Boxes.
To review detailed reports on capitated payments, visit the Reports section on your Secure Provider Portal, or reach out to your Provider Engagement Coordinator for help!
Sharing from the July 22, 2021 Medicaid Bulletin
Durable Medical Equipment (DME) is covered under NC Medicaid Managed Care for beneficiaries enrolled in a managed care plan and under NC Medicaid Direct for those beneficiaries who remain in NC Medicaid Direct. DME is NOT carved out of managed care.
Pharmacies and other providers that provide DME to NC Medicaid Managed Care beneficiaries should contract with or update contracts with health plans to include a DME agreement to be able to bill DME products, which are a DME benefit, for NC Medicaid Managed Care beneficiaries. For beneficiaries enrolled in NC Medicaid Direct, providers can continue to submit claims through NCTracks. For beneficiaries enrolled in managed care plans, please contact the plan directly for more information.
To contract with Carolina Complete Health, please email NetworkRelations@cch-network.com
Carolina Complete Health will issue the first set of medical home fee payments to providers on or before Saturday, July 24, 2021. Paper checks will be sent by Priority Mail this month. Beginning in August, payments will be distributed on the 20th of each month.
To view our Claims Submission Reminder Guide, please visit Manuals, Forms, and Guides. This guide provides tips on Taxonomy placement and common causes of claims delays, denials, and rejections.
Health plans have identified a common billing error of providers submitting professional and institutional EDI claims (ASC X12 837-P and ASC X12 837-I) with missing or invalid billing provider, rendering provider and attending provider taxonomy codes.
When billing NC Medicaid Direct claims, providers may have directed clearinghouses to append billing provider, rendering provider, or attending provider taxonomy codes to the claims. This process may not have been established for NC Medicaid Managed Care claims being submitted to the prepaid health plans (PHPs), causing these claims to deny for missing or invalid taxonomies.
Providers should work with their clearinghouses to ensure that the same processes are followed when submitting claims to NC Medicaid Direct and the PHPs.
To facilitate timely adjudication, providers should include the billing provider taxonomy and, when applicable, the rendering provider taxonomy and attending provider taxonomy on claims before sending them to a clearinghouse.
For claims that have been submitted to PHPs and denied for invalid billing, rendering, or attending provider taxonomy codes, please immediately resubmit the denied claims using the process outlined above. For assistance, please follow up with the PHP your agency contracts with.
Please refer to the July 9, 2021, Common Billing Error: Taxonomy Codes Missing, Incorrect or Inactive bulletin for additional guidance on submitting valid taxonomy codes.
Effective July 1, 2021, an Explanation of Benefits (EOB) was added to NCTracks for pharmacy claims: EOB 2093 - SUBMIT CLAIM TO THE PHP FOR SERVICES INCLUDED IN THE MANAGED CARE PLAN.
This EOB is received when a pharmacy claim is denied due to the beneficiary being enrolled in Medicaid Managed Care. When a claim is denied for this cause, NCTracks will send the name of the Managed Care Plan that beneficiary is enrolled with, as well as information related to submitting pharmacy claims to that Managed Care Plan, on the pharmacy claim response transaction.
Pharmacy claim response transactions will include one of the following messages (as applicable) on the claim denied with edit 2093:
Carolina Complete Health can arrange and pay for member transportation to and from appointments for Medicaid-covered services.
How to Get Non-Emergency Transportation:
Call ModivCare, Carolina Complete Health's transportation provider, up to 30 days before the appointment to arrange for round-trip transportation. There is no limit to the number of trips during the year between medical appointments, healthcare facilities, or pharmacies.
ModivCare Support Numbers:
How far in advance can Members make reservations?
A customer service representative will ask for the following information:
For more information on Carolina Complete Health Transportation Services, please visit the Transportation Services page
For Non-Emergency Medical Transportation (NEMT) fact sheets, please see the NEMT page on the County Playbook, available from North Carolina Medicaid Division of Health Benefits.
DHHS and Division of Information Technology staff will be making updates in the Live IRIS System in preparation for Medicaid Transformation. NC IRIS is expected to be available at 8:00 a.m. on Thursday, July 1st for providers to begin submitting incident reports. Please contact Carolina Complete directly with any questions.
The Incident Response Improvement System (IRIS) is a web based incident reporting system for reporting and documenting responses to Level II and III incidents involving consumers receiving mental health, developmental disabilities and/or substance abuse services.
Due to the passage of SL 2021-62, effective July 1, 2021 , the following services are carved out of NC Medicaid Managed Care and should continue to be billed through NCTracks:
CDSAs and independent practitioner providers providing IFSP services for the CDSA should hold their claims from July 1, 2021, through July 12, 2021, for dates of service starting on July 1, 2021.
For more information, please see the Medicaid bulletin article Children’s Developmental Services Agency Providers Carved Out of Managed Care.
Sharing on behalf of The White House:
Dear North Carolina Primary Care Providers,
On behalf of the White House COVID-19 Response Team and North Carolina Governor Roy Cooper’s Office, I am pleased to invite you to a virtual conversation on North Carolina Primary Care Providers and the Vaccination Rollout. The event is on Tuesday, June 29, from 4:00 – 5:00 PM ET.
The conversation will be an opportunity to express gratitude to North Carolina’s primary care providers for their service to their patients, state, and country throughout the COVID-19 response and vaccine rollout. Speakers will discuss the critical role primary care providers continue to play in this phase of the vaccination effort -- including through vaccine education to their patients and through offering vaccinations in their offices -- and the tools the federal government and State of North Carolina are providing to support them. Attendees will hear from fellow primary care providers in North Carolina on innovative approaches they are taking to patient outreach and implementing their own vaccination programs. Additionally, attendees will be able to pose questions about the role of primary care providers in the current phase of the vaccination effort and the challenges or concerns they face.
Please see information for how to register for the event below. We look forward to seeing you there.
Dr. Bechara Choucair; National Vaccinations Coordinator, White House COVID-19 Response Team
Dear Carolina Complete Health Partner:
In an effort to promote transparency and partnership, Carolina Complete Health (CCH) would like to provide an immediate update on the status of our auto-assignment process.
Due to a data issue in the auto-assignment algorithm at CCH, some members were assigned to physicians/providers with whom they did not have a previous affiliation. CCH has corrected the data issue, will be properly reassigning members, and will be reissuing new member ID cards. All new member ID cards will be mailed by June 22, 2021. If members have not received their replacement cards by June 28th, they should contact Member Service at 1-833-552-3876.
Correct member attribution and ensuring our members receive the care they need from the physicians/providers they choose is of upmost importance to CCH. We apologize for any administrative burden that this may cause as we ensure that member choice is honored in every situation.
CCH is committed to working with each provider to answer questions regarding your CCH patient panel. Our Provider Engagement Team is committed to supporting you through this resolution and will be reaching out to you to confirm that you are in agreement with the members assigned to your panel. The updated provider panel will be available on our Secure Provider Portal on or before July 1, 2021.
Thank you for being a trusted partner with CCH, the only provider-led-entity in Medicaid Transformation. If you have any questions, please contact us at 1-833-552-3876.
On June 14, the Department released updated Fact Sheets:
Please note that on the Introduction to Medicaid Transformation: Part 2 – Enrollment and Timelines it is indicated that mandatory beneficiaries (required to enroll in a health plan) have a 90-day choice period in which they can change health plans for any reason. The 90-days start as of the effective date of enrollment. Beneficiaries have 30 days after PCP assignment to change their PCP. Carolina Complete Health members can change their PCP by calling member services at 1-833-552-3876
As a Provider-Led health plan, Carolina Complete Health understands the unique cash flow challenges that providers manage. As we transition to Medicaid Managed Care, we want to minimize impacts and have included the payment schedule below so you can plan.
First Claims Payment
First Claims DOS
July 8, 2021
July 1 – 7, 2021
July 13, 2021
July 1 – 9, 2021
Weekly, Tuesday and Friday
July 13, 2021
July 1 – 9, 2021
Weekly, Tuesday and Friday
July 14, 2021
July 1 – 7, 2021
Carolina Complete Health offers trainings and toolkits for both behavioral health and physical health providers in our network at no cost. Our team provides mostly clinical, provider-focused education on topics that are geared towards improving member outcomes. The majority of our clinical trainings also offer behavioral health continuing education units also at no cost to the attendee. Trainings are completed via live/virtual instructor led webinars. Visit the Behavioral Health Resources page for more information and additional resources.
On May 19th, Chief Justice Paul Newby announced plans to integrate practices and policies based on the science of adverse childhood experiences in North Carolina’s 6,500-person,100-county statewide judiciary. This makes North Carolina the first state to implement ACE's informed courts.
"The announcement featured a presentation by Ben David, district attorney for North Carolina’s 13th District, that focused on building community health, the science of adverse childhood experiences (ACEs), and how communities can engage service providers and courthouse professionals to work together to prevent crime and reduce recidivism."
Research tells us that childhood trauma increases the likelihood that these children could end up in the courtroom either as the defendant or as a victim.
For more information or to view a recording of this special presentation and announcement, visit PACE's Connection
National Imaging Associates, Inc. (NIA)
May 12, 2021
The Carolina Complete Health Billing Manual has been updated to reflect an additional clearinghouse.
You can find the updated Billing Manual under Resources: Manuals and Forms
Carolina Complete Health is excited to share that Duke will be a participating health system in Medicaid Managed Care. Visit the Plan for Duke webpage for more information on which PHPs Duke will be accepting in Medicaid Managed Care
This past year presented so many different challenges and obstacles that tested our strength and resiliency. The global pandemic forced us to cope with situations we never even imagined, and a lot of us struggled with our mental health as a result. The good news is that there are tools and resources available that can support the well-being of individuals and communities.
Now, more than ever, we need to combat the stigma surrounding mental health concerns. That’s why this Mental Health Month, Carolina Complete Health Network is highlighting #Tools2Thrive - what individuals can do throughout their daily lives to prioritize mental health, build resiliency, and continue to cope with the obstacles of COVID-19.
If you found that it impacted your mental health, you aren’t alone. In fact, of the almost half a million individuals that took the anxiety screening available through Mental Health America online, 79% showed symptoms of moderate to severe anxiety. However, there are practical tools that can help improve your mental health.
Ultimately, during this month of May, Carolina Complete Health Network wants to remind everyone that mental illnesses are real, and recovery is possible. By developing your own #Tools2Thrive, it is possible to find balance between life’s ups and downs and continue to cope with the challenges brought on by the pandemic.
For more information, visit Mental Health America.
To assist with identifying North Carolina Medicaid and NC Health Choice beneficiaries currently assigned under the Community Care of North Carolina/Carolina ACCESS (CCNC/CA) program, NCDHHS generated a new Advanced Medical Home (AMH) NC Medicaid Direct/NC Medicaid Managed Care Primary Care Provider (PCP) Enrollee Report for distribution to CCNC/CA participating providers.
The report, initially made available on March 15, 2021, is delivered each month to the NCTracks Secure Provider Portal Message Inbox the Monday before the second checkwrite to coincide with the receipt of CCNC/CA management fees.
The AMH Medicaid Direct/Managed Care PCP Enrollee Report contains a list of all NC Medicaid beneficiaries who have been assigned to the identified NPI in the past 12 months and contains:
To effectively use the report, add filters or sort the report based on an Active status of “Y.” In this way, the provider can narrow the results to display only those currently enrolled in NC Medicaid and assigned to the identified NPI.
In addition to the Active status, the End Date of assignment will display the current eligibility span for the beneficiary which includes the provider assignment.
Centene partnered with YWCA USA over the course of three years to create, pilot, evaluate, and revise Young Women Choosing Action, a research-based, innovative program. The program was created to engage youth aged 13 to 19 from low income families, especially individuals of color.
Young Women Choosing Action is a culturally and gender-responsive education and leadership program, enabling participants to learn real-world leadership skills. Funded by a grant from Centene, the program helps participants understand the impacts of trauma, manage unhealthy reactions, and develop healthy relationships.
Three overarching goals were defined at the beginning of the project. These goals were aimed at improving participants' ability to:
Sharing information from recent NC DHB Medicaid Bulletin articles:
Throughout CAP Month, Prevent Child Abuse North Carolina (PCANC) and its stakeholders are amplifying the message that together, we can build stable foundations for children through caring connections, supportive environments, and positive experiences.
Prevent Child Abuse NC ensures that prevention is a priority in North Carolina and that all communities have the knowledge, skills, and resources to prevent child abuse and neglect at the local level.
Prevent Child Abuse NC offers support to interested community members who want to build Community Prevention Action Plans (CPAPs). You can learn more about each CPAP happening throughout the state by visiting each of the county pages. Carolina Complete Health Network is also proud to be particpating in various ACEs and Resiliency community collaboratives throughout our regions. If you would like to learn more about initiatives in your community, or if you are interested in a Communtiy Resiliency Model Training, please reach out to Jesse Hardin
Sharing from the North Carolina Medical Society, a founding partner of Carolina Complete Health Network:
The spring issue of your NCMS Bulletin focuses on the COVID-19 crisis and its impact on health care in North Carolina. Read NC Department of Health and Human Services Secretary Mandy Cohen’s, MD, MPH, views on how health care may be different post-pandemic. Also see how the NCMS Foundation has responded during this critical time in health care and in our nation’s history.
In this issue:
Join the CCHN Provider Engagement team on a New Provider Orientation. For instructions on how to attend, please visit our education and training site.
New Provider Orientations will cover:
Each year on March 30, National Doctors’ Day honors these healthcare professionals for their dedication and contributions to the medical society and the community.
This past year has been a paradigm shift for the practice of medicine and changes in state-wide and global health policies. We honor you this National Doctors Day, for your dedication to your oath and compassion for your patients. We celebrate you, as a leader, embarking on the journey with us in creating a physician-led health plan, empowering healthcare professionals to care for Medicaid beneficiaries in North Carolina.
The first Doctors’ Day observance was March 30, 1933, when Eudora Brown Almond, wife of Dr. Charles B. Almond, set aside a day to honor physicians, by mailing greeting cards to physicians, and placing red carnations of the graves of deceased doctors in Winder, Georgia.
National Doctors Day was set as March 30, as this date in 1842, Crawford W. Long, MD, completed the first ether anesthetic surgery. In 1990, legislation was passed to establish this National Doctors Day
Providers including pediatricians, physician assistants, nurse practitioners, and nurses in primary care practices in North Carolina who have individuals with an autism spectrum disorder of any age on their caseload and who would like to develop their expertise in working with this population.
If you are interested, please email: firstname.lastname@example.org
For mor information, visit UNC's TEACCH Autism Program
In case you missed it! The NC Population Health Collaborative met on March 11th with NC DHHS representatives to discuss the latest on Medicaid Transformation. The recording is available through the North Carolina Medical Society
Sharing from the March 3 NCMS Morning Rounds:
The requirement to check the NC Controlled Substances Reporting System (NC CSRS) before prescribing certain controlled substances will take effect soon, although a specific date has not yet been set. This mandate is a provision in the STOP Act (Strengthen Opioid Misuse Prevention Act), which was signed into law in June 2017 to help stem the opioid abuse crisis.
In the latest issue of its Forum newsletter, the NC Medical Board states that its staff has been notified by the NC Department of Health and Human Services' (NCDHHS) Drug Control Unit, which runs NC CSRS, that all system upgrades and requirements that, by law, must be completed before the requirement can be in effect have been finished.
Although there is still no specific effective date for mandatory NC CSRS use, it's clear that it won't be long now. Register here, if you haven't yet.
You can review the specific requirements of the law at this link to the statute, §90-113.74C (a) (PDF). The NCMB also provides the following summary.
Prior to prescribing a Schedule II and Schedule III opioid or narcotic, practitioners are required to review a patient’s 12-month prescription history in the NC CSRS. For every subsequent three-month period that the Schedule II or Schedule III opioid or narcotic remains part of the patient’s medical care, practitioners are required to review the patient’s 12-month history in the NC CSRS.
Reviews should be documented within the patient’s medical record along with any electrical or technological failure that prevents such review. Practitioners are required to review the history and document the review once the electrical or technological failure has resolved.
Certain practitioners may, but are not required to, review the NC CSRS prior to prescribing a targeted controlled substance to a patient in any of the following circumstances:
The STOP Act authorizes NC CSRS to conduct periodic audits to determine prescriber compliance with review requirements. The law states that NC CSRS shall report to the Board any licensee found to be in violation of the requirement to check NC CSRS; violations may result in regulatory action by the Board.
Do you have questions about:
To answer these questions, please join NC Medicaid for a webinar on Thursday, March 11, 2021 from 12 noon to 1 p.m. where they will provide a webinar on the NCDHHS Transition of Care Policy.
Please pre-register for the webinar.
Join the NC Population Health Collaborative on March 11 from 11 a.m. to 1 p.m. when it will address ‘The Journey Towards Medicaid Managed Care: Get Your Go Bag Ready!’ This session will cover many important items to remember in the final days before Medicaid Managed Care goes live, including issues around AMH and COVID Coverage policies! Learn more and register here.
The state will transition to Medicaid managed care as of July 1, 2021 and to help practices prepare for this change, Medicaid Transformation Provider Services and North Carolina AHEC are conducting a series of Virtual Office Hours for those who serve Medicaid beneficiaries beginning in March 2021. These sessions offer an interactive format to have your questions answered on a range of topics related to Medicaid Managed Care.
The first session will be held on Tuesday, March 2 at 4 p.m. and the focus will be on the Medicaid Provider Directory. The presenter will be Christina Bunch, Associate Director of Provider Operations, NC Medicaid Transformation, NC Department of Health and Human Services. The webinar will be moderated by Chris Weathington, NC AHEC Practice Support. Register here.
Providers are encouraged to submit questions in advance to Medicaid.email@example.com for discussion. Virtual Office Hours will cover a range of Medicaid Managed Care topics.
Check out North Carolina Family Medicine's podcast to learn about resources, tools and incentives for practices achieving Advanced Medical Home Tier 3 status. This podcast episode features Nicole Cannady, SEAHEC Practice Support Coach with Carol Stanley, Medicaid Transformation Manager for the NC AHEC Practice Support Team.
They discuss tools that NC AHEC has available to help primary care practices achieve Advanced Medical Home (AMH) Status, the differences between a Tier 2 and a Tier 3 AMH, and what family medicine and other primary care practices should be doing now to prepare for Medicaid Managed Care in North Carolina. The two also discuss significant financial incentives for practices who achieve AMH Tier-3 status early, and how those incentives can impact your practice.
This episode is also available on popular podcast apps
If you would like to be referred for services from your local AHEC, please reach out to your Provider Engagement Coordinator and we are happy to assist in connecting you. You can also visit the NC AHEC Practice Support Webpage
Published by NC Child and the NC Institute of Medicine, North Carolina’s latest Child Health Report Card gives the state high marks for children’s health coverage, but also points out some troubling trends.
North Carolina earned failing grades in several key areas, including Mental Health, Substance Use, Birth Outcomes, and Housing & Economic Security. The data sources for this release pre-date the current pandemic and associated economic downturn. However, the report card also highlights current data snapshots pertinent to children’s health, and the impact of the pandemic on children and families.
“Even before the pandemic struck, we had a long way to go to improve health outcomes for North Carolina’s children - especially some of our biggest challenges, like ensuring healthy births for families of all races and economic means,” said Kathy Colville, President and CEO of the NC Institute of Medicine. “We know our state has made great strides in areas such as children’s health insurance coverage and childhood immunizations. We want to apply the successful approaches in those areas to the other health issues facing our kids and families.”
“Children have the best chance of thriving and living full lives when they have access to physical and mental health care, education, adequate nourishment, safe housing, and high-quality child care,” said Michelle Hughes, executive director of NC Child. “Our state’s leaders have a responsibility to make wise policy choices that support children and families at all times – and especially in times of crisis.”
As the state legislature convenes for the 2021 “long session,” policy-makers have several opportunities to address some critical points for children’s health in North Carolina highlighted in the Report Card.
Strengthening health coverage as a crucial part of North Carolina’s public health response to COVID-19. Expanding access to affordable health coverage - for adults and children alike - is important to children’s physical, mental, and emotional health. When parents are insured, they are better able to stay healthy and care for their children. Likewise, their children are more likely to have health insurance and to use it. Hundreds of thousands of North Carolina caregivers have lost the health coverage they previously received through their employers. Without health insurance, it can be nearly impossible for parents and caregivers to get health care when they need it. Affordable health coverage has also been proven to be an important bulwark against economic hardship for families.
Preventing long-term harm to kids by investing in the programs that are proven to insulate families against the harmful effects of poverty. Programs such as Medicaid, SNAP, WIC, and high-quality early childhood education are proven to boost school success and help keep kids healthy throughout their lives.
Expanding access to broadband internet. State legislators have an opportunity to get broadband internet to the estimated 200,000 homes with students in North Carolina that still have no internet access at home. Currently, these families don’t have the wi-fi access they need for their kids to attend class remotely. Without high-speed internet, families often cannot use telehealth services, search & apply for jobs, or apply for vital benefits like Medicaid or SNAP, particularly during the pandemic.
Burlington Pediatrics has been invited by the American Medical Association to present at its upcoming webinar, Overcoming Obstacles: Sustaining Behavioral Health Care in Your Practice, Feb 25th. The focus will be on the challenges and strategies related to integrating behavioral health in an independent practice.
Khadijia Tribié Reid, MD, MPH, FAAP, Pediatric Medical Director of MedNorth Health Center, is featured as the "Giving Voice" on episode 44 of the official podcast from the American Academy of Pediatrics, "Pediatrics on Call." Dr. Tribié Reid discusses how integrating physical and behavioral health has transformed patient care at MedNorth, an FQHC in downtown Wilmington. Specifically, she presents a case-study that is all too familiar to physicians today and how by screening for behavioral health conditions and Adverse Childhood Experiences (ACEs), as well as collaborating with in-house behavioral health clinicians, they are seeing improved patient outcomes.
"Giving Voice" is also available on popular podcast platforms.
If your practice would like more information about behavioral health integration, the ACEs screening, or resiliency training, please contact Jesse Hardin, Senior Provider Engagement Coordinator firstname.lastname@example.org
Featuring Karen Smith, MD and Michaela Latham
Join the North Carolina Medical Society as they discuss practice finances in the wake of the current Covid-19 Pandemic. Hear from rural medical business owner Dr. Karen Smith along with the practice’s Population Health Administrator, Michaela Latham, as they review the financial lessons learned through the Pandemic and how building financial resiliency is key to practice stability. This webinar will discuss the practical aspects of recovering from the costly impacts of Covid, and what is being done to build up their practice resiliency for a stronger, more stable future.
On July 1, 2022, the Department of Health and Human Services will launch the statewide Specialized Foster Care Plan. This specialized plan is intended to meet the unique needs of North Carolina children and youth currently and formerly involved in the child welfare system and to address receiving seamless, integrated, and coordinated health care.
The Foster Care Plan will integrate comprehensive physical and behavioral health services while maintaining treatment plans when placements change. This plan will also include care management services to improve coordination among service providers, families, involved entities (such as the Department of Social Services, Division of Juvenile Justice, schools) and other stakeholders involved in serving Foster Care Plan members.
To access the white paper on North Carolina's Specialized Foster Care Plan or to view a recent webinar providing an overview of this plan, visit the DHHS website for the Specialized Foster Care Plan
Governor Cooper has proclaimed February as Parenting Education Awareness Month for the state of North Carolina. NC has a plan to build a statewide home visiting and parenting education system. This model is proven to impact prenatal health & birth outcomes. Universally available, voluntary home visiting and parenting education programs can improve families' wellbeing and improve racial equity by providing families with the support needed to ensure children are safe and health. Smart Start of North Carolina is working to develop an action plan that will develop a comprehensive, statewide system encompassing both home visitng and parent education in North Carolina. To reach out to your local Smart Start, visit the Smart Start in Your Community directory.
NC AHEC is hosting a webinar dedicated to discussing the AMH Tier 3 Glide Path incentive opportunity!
Thursday, Feb. 11 | 5:30 p.m. – 6:30 p.m.
This series is designed to support practice managers, quality improvement professionals, care coordinators, and others within your practice who are responsible for meeting the NC Medicaid AMH Tier requirements.
For more information, please see Advanced Medical Home Tier 3 “Glidepath” Payments.
Be sure to join to learn more!
Hosted by Shannon Dowler, MD, Chief Medical Officer, NC Division of Health Benefits and moderated by Hugh Tilson, Director, NC AHEC Program. This month's fireside chat topic is all about quality! To register, visit the NC AHEC Website
Fireside chats take place on the first Thursday of ever month and cover a wide range of topics pertaining to Medicaid Managed Care. Future topics include:
The North Carolina Division of Public Health (DPH), in partnership with NC Area Health Education Centers (NCAHEC) and Community Care of North Carolina (CCNC), are providing grants to independent pediatric and family medicine practices to support interventions aimed at boosting compliance with scheduled immunizations and well-child care. Rates of childhood vaccinations have fallen sharply during the pandemic, leaving children and the adults around them vulnerable to preventable diseases. These grants are intended to provide additional resources to independent primary care practices working to address the problem.
Grants of up to $5,000 maximum per organization will be awarded upon successful completion of the intervention. In addition, practice support coaches from NC AHEC and CCNC will be available to assist in this effort.
Funds are limited and are distributed to accepted applicants on a first come, first serve basis, so you are encouraged to apply as soon as possible. Practices will be notified of approval within 1-2 weeks after submitting an application. Practices should then submit data reflecting the aggregate number of children served regardless of payor status, and provide W-9 documentation within two weeks of the completed intervention and no later than May 31, 2021. All required documentation should be sent to email@example.com in order to receive payment.
*All Medicaid Prepaid Health Plan (PHP) contracts signed prior to the delay will remain in effect unless otherwise specified or termed by the individual PHP or Provider. There is no need to request a new contract at this time if you obtained a fully executed contract prior to the delay
Contact CCHN, Your Provider-led Plan!
Your regional CCHN Provider Engagement Coordinators are also here for you!
Your provider engagement coordinator will be reaching out to schedule your provider orientation. Our goal is to customize this process to what works best for YOU and we would love your input! We invite you to complete this survey so we can gather a few of your preferences. Orientations will be conducted 90 days before go-live.
As North Carolina moves closer to implementing Medicaid managed care, the state has published additional information in its NC Medicaid Provider Playbook to help you make the transition. The move to managed care is set to ‘go live’ July 1.
One fast approaching date to keep in mind is Feb. 1, which is the deadline for you to contract with the pre-paid health plans (PHPs) if you want to be included in the open enrollment phase of the transition.
More information on contracting and the timeline are included in these updated parts of the playbook:
Please take a moment to complete the latest practice survey from NCMS, MGMA, and Curi. Watch your NCMS Morning Rounds for an upcoming summary of the trends they have tracked since last March to assess the needs and challenges facing medical practices throughout the state. This data helps to allocate resources as you navigate the COVID-19 pandemic and provide important points of information to state officials and policymakers.
NCDHHS launched an online portal for primary care providers to request reimbursement for COVID-19 related costs for individuals without insurance. Providers can go to the NCTracks secure portal to access the reimbursement portal.
Primary care providers can receive $150 for each in-person or telehealth visit of eligible COVID-19-related care for uninsured individuals living in North Carolina. To be eligible for reimbursement, providers must operate in North Carolina and be registered in NCTracks, North Carolina’s Medicaid provider payment platform. NCDHHS is reimbursing providers on a first-come, first-serve basis for up to $7.8 million in total support. Funds are available through December 30, 2020, or until they’ve been spent. Claims will be reimbursed retroactively to September 1, 2020.
Greensboro AHEC is launching an ECHO (Extension for Community Healthcare Outcomes) program to support practices to integrate behavioral health into the primary care medical home. Behavioral health integration is a central component to Medicaid Managed Care and successful integration requires a system of care transformation. For more information and to register, visit the course page.
This Fireside Chat series on the third Thursday of every month features topics related to clinical quality. This webinar focuses on behavioral health issues.
· Impact of COVID Pandemic on Mental Health – National perspectives and data
· Impact of COVID on Mental Health – State perspectives and data
· Update: Division of Health Benefits Policy Changes
· Innovative behavioral health models and “best practices”
Thursday, December 17, 2020
5:30 PM to 6:30 PM
Register in advance
North Carolina has a plan for COVID-19 vaccine distribution. Come learn more with Dr. Betsey Tilson and other experts. For a list of archived COVID webinars, visit NC AHEC
Initial shipments of the coronavirus vaccine will go to about 50 to 60 hospitals in the state, according to Dr. Mandy Cohen, Secretary of the NC Dept. of Health and Human Services. The Pfizer vaccine must be kept in special freezers at ultra-low temperatures before it is ready to use, and not all hospitals have them. To work, the vaccine needs to be administered twice, 21 days apart. North Carolina’s plan for vaccination includes inoculating frontline health-care workers, including those who clean around COVID-19 patients, and staff in emergency rooms. Next on the list are people who live and work in long-term care facilities. For the full article, visit the News Observer
DHHS will implement a new $8.51 PMPM payment stream to AMH Tier 3 practices 90 days prior to the launch of Managed Care to assist with and incent Tier 3 preparation. Payments will flow to practices in the same way as current CA II Payments. Qualifying practices will receive $8.51 PMPM direct from NC Tracks for each month in which they meet the conditions listed below, up to three times.
Tier 3 Glide Path Payment Eligibility Criteria:
1. AMH Tier 3 within NC Tracks
2. Contracting completed with at least two PHPs
3. Data exchange testing successfully completed with at least two PHPs
4. Practice has completed attestation in NC Tracks provider portal that items 2-3 complete.
DHHS will release additional details on the above criteria in early 2021.
For more information, feel free to contact your CCHN Provider Engagement Coordinator!
Beginning in December 2020, a new Medicaid Managed Care webinar series on the Advanced Medical Home (AMH) program will provide Medicaid primary care practice staff and clinicians with more information on North Carolina’s AMH model and how to function at the highest AMH Tier possible when Medicaid Managed Care goes live in July 2021.
Beginning December 10, 2020, a new Medicaid Managed Care webinar series from NC AHEC on the Advanced Medical Home (AMH) program will provide Medicaid primary care practice staff and clinicians with more information on North Carolina’s AMH model and how to function at the highest AMH Tier possible when Medicaid Managed Care goes live in July 2021. This webinar series will occur the second Thursday of each month beginning December 10th and continue through May. Register in advance for this series.
The North Carolina Department of Health and Human Services (NC DHHS) Division of Health Benefits and North Carolina AHEC continue to offer monthly webinars covering managed care and clinical quality topics. Hosted by Shannon Dowler, MD, Chief Medical Officer of the NC Division of Health Benefits, these take place on the first and third Thursday of each month
Register for the Medicaid Managed Care Topics- every first Thursday of the Month 5:30-6:30
Register for the Clinical Quality Topics – every third Thursday of the Month 5:30-6:30
Safety net organizations are facing increasing demand for access to services in communities across our state, not the least of which has been the current Novel Coronavirus pandemic. Safety net organizations have had to quickly adapt to the new environment to improve access and sustainability.
These grant funds, supported through the North Carolina General Assembly, are for assuring access to primary and preventive care to meet the health needs of our state’s most vulnerable populations. Strengthening the safety net through increased levels of collaboration and integration of services and organizations to more effectively sustain and meet the needs of those served is also an important purpose of this grant. Visit DHHS Grant Opportunities for more information and attend a technical assistance webinar listed below:
Technical Assistance Webinars (Interested applicants may attend any session at their convenience)
November 16, 2020 at 10:00 a.m. – Regions 4 and 6
Register in advance
Meeting number: 173 412 4222 Password: CHG2021
Join by phone
+1-415-655-0001 US Toll
Access code: 173 412 4222
November 16, 2020 at 2:00 p.m. – Regions 3 and 5
Register in advance
Meeting number: 173 813 2880 Password: CHG2021
Join by phone
+1-415-655-0001 US Toll
Access code: 173 813 2880
December 7, 2020 at 10:00 a.m. – Regions 1 and 2
Register in advance
Meeting number: 173 128 0770 Password: CHG2021
Join by phone
+1-415-655-0001 US Toll
Access code: 173 128 0770
The Advanced Medical Home Tier Attestation Tool, available on the NCTracks Secure Provider Portal Status and Management page has been modified. Providers may use this tool to downgrade from an AMH Tier 3 level provider to an AMH Tier 2 level provider. For more information, see the November 3rd Medicaid bulletin
DHHS has announced the launch of NC Medicaid’s managed care enrollment website, www.ncmedicaidplans.gov, in preparation for the launch of Medicaid Managed Care scheduled on July 1, 2021. Medicaid Managed Care open enrollment will begin March 15, 2021 and will continue through May 14, 2021.
It is extremely important for providers to act now and review their information is up to date and correct in NCTracks, both at the practitioner and organizational level. Accurate information will support beneficiaries in the new Provider & Health Plan Look-up tool, expected to launch January 1, 2021. For more information, view the September 25 Medicaid bulletin
Carolina Complete Health is proud to partner with the North Carolina Community Health Center Association (NCCHCA) on Medicaid transformation. Through this unique partnership, we will be able to bring provider-led solutions to improve the health North Carolinians. NCCHCA has their own podcast, NC Community HealthCast! They talk with Community Health Center (CHC) staff, patients, friends, and allies about everything important to the Federally Qualified Health Center and safety net world.
You can also find this on podcast on Google podcasts, Pandora, Apple, and more!
Tuesday, November 10, 2020 | 12:00 pm to 1:00 pm
Join NCMS Foundation for a webinar to review and discuss updates of the recently launched state-funded program, which is overseen by the North Carolina Medical Society Foundation and seeks to distribute grants to independent medical practices that have suffered financially due to the Covid-19 pandemic. Learn what the criteria are for applying and how your practice can benefit from the FRP.
Carolina Complete Health is proud to partner with the North Carolina Medical Society (NCMS) on Medicaid transformation. Through this unique partnership, we will be able to bring provider-led solutions to improve the health North Carolinians. The NCMS Foundation is proud to oversee the state-funded Financial Recovery Program (FRP) to assist eligible practices throughout the state that are experiencing economic distress due to the pandemic. Funding will be based on reimbursement for COVID-19-related expenses incurred between March 1 and November 30, 2020. The deadline to apply is November 30, 2020 with no exceptions. Visit the North Carolina Medical Society for more information.
Tuesday, November 10, 2020 | 12:00 pm to 1:00 pm
This webinar will review and discuss updates of the recently launched state-funded program, which is overseen by the North Carolina Medical Society Foundation and seeks to distribute grants to independent medical practices that have suffered financially due to the Covid-19 pandemic. Learn what the criteria are for applying and how your practice can benefit from the FRP.
This webinar is free but you must be registered to attend. Space is limited so register early:
Presented by the North Carolina Medical Society Foundation in cooperation with the North Carolina Medical Group Management Association.
NCCHCA has their own podcast, NC Community HealthCast! They talk with Community Health Center (CHC) staff, patients, friends, and allies about everything important to the Federally Qualified Health Center and safety net world.
All Medicaid Pre-paid Health Plan (PHP) contracts signed prior to the delay will remain in effect unless otherwise specified or termed by the individual PHP or Provider. There is no need to request a new contract at this time if you obtained a fully executed contract prior to the delay. For more information, visit the NC DHHS Provider Playbook.
Funding will be based on reimbursement for COVID-19-related expenses incurred between March 1 and November 30, 2020. Your practice is eligible if it falls in ALL of the following categories:
The deadline to apply for the Financial Recovery Program (FRP), is Nov. 30, 2020 with no exceptions. Apply for the FRP
Attend a FREE Financial Recovery Program Lunch & Learn Webinar at 12PM on Tuesday, October 13, 2020. Register in advance for this meeting
Even if you currently have an adequate supply of personal protective equipment (PPE), we encourage you to take advantage of the FREE PPE the NCMS is distributing to independent practices throughout the state. Be prepared for whatever the future may hold and stockpile this PPE. The deadline to order is Nov. 15. Learn more about this program and order today.
Suicide is the 10th leading cause of death in the United States.1 Current research identifies poor mental health and burnout as an epidemic for physicians and a public health crisis.2 According to The Council of Residency Directors in Emergency Medicine (CORD), “while estimates of the actual number of physician suicides vary, literature has shown that the relative risk for suicide being 2.27 times greater among women and 1.41 times higher among men versus the general population.”3
At Carolina Complete Health Network, we care deeply about your well-being. We are a proud subsidiary of the North Carolina Medical Society, who in 2016 advocated to change the way the NC Medical Board collected health information from renewing licensees. Beginning in 2017, the Board shifted their approach and no longer required physicians seeking renewal to disclose specific details, but rather, acknowledge a statement and agree to appropriately address their health conditions, including mental health and substance use.
Below you will find a collection of resources to promote well-being, including supportive options for mental health and substance use:
For two decades, September is used to observe healthy again practices. Carolyn Worthington, editor-in-chief of Healthy Aging® Magazine and executive director of Healthy Aging® says September is Healthy Aging® Month provides inspiration and practical ideas for adults, ages 45-plus, to improve their physical, mental, social and financial well-being.
Join the National Council for Behavioral Health’s Behavioral Health Training Institute (BHTI) for Health Officials and the Association of State and Territorial Health Officials (ASTHO) on Thursday, September 10 from 3-4 p.m. ET for “Avoiding COVID-19 Burnout: Self-care and Resiliency for Public Health Leaders.” Register in advance.
Under the direction of NC DHHS, NC AHEC and CCNC will support practices to increase well-child checks and immunization rates. NC has experienced a decline of care in these categories since the start of the COVID-19 pandemic. Read more information and access hands on support through CCNC and AHEC.
NC DHHS is working towards a state-wide roll out for Medicaid Managed Care on July 1, 2021. Stay current with NC DHHS updates on the Medicaid Transformation homepage.
The NCMS secured a $5 million grant from the NC General Assembly to distribute FREE PPE to independent practices in North Carolina. Visit NCMS for more information and instructions on how to access this free PPE.
For more than thirty years, National Health Center Week (August 9 – 15) has been celebrated to recognize the mission of America’s health centers. North Carolina health centers are a critical safety net provider for over half a million patients and embody the medical home model for our some of our most vulnerable community members. The theme for this year is: Lighting the Way for Healthier Communities Today and in the Future.
Carolina Complete Health is the only Medicaid plan in North Carolina led by doctors from the North Carolina Medical Society and the North Carolina Community Health Center Association.
Stop Unhealthy Alcohol Use Now (STUN) is a new initiative from NC AHEC supporting practices to implement evidence-based interventions such as screening and brief interventions for adult patients with unhealthy alcohol use.
We strongly encourage our CCHN practices to learn more. Please reach out to your CCHN Provider Engagement Coordinator so we can connect you with your AHEC Practice Support. If you have questions, you can also email NC AHEC directly at firstname.lastname@example.org.
The North Carolina Fetal Alcohol Prevention Program (FASDinNC) is partnering with Northwest AHEC to provide a four-part webinar series covering a range of topics surrounding FASD. This series will run for four consecutive Thursdays and includes state and national experts. The dates are: August 27th, September 3rd, September 10th, and September 17th.
Governor Roy Cooper announced that the NC Community Health Center Association (NCCHCA) is the third approved vendor to begin COVID testing in historically marginalized communities. NCCHCA will begin no-cost testing events throughout 23 zip codes. Visit the COVID-19 dashboard for an up to date list of community testing events.
Advancing patient and family engagement is shown to be an integral component of cultural inclusivity and health equity. NatioEnal Academy of Medicine (NAM) Leadership Consortium Culture & Inclusiveness Action Collaborative recently published a paper containing a framework for transformation.
Patient and family engagement is more critical during a public health crisis, however guidelines for physical distancing may inhibit the physical presence of family members during a visit. The Journal of Pain and Symptom Management recently published strategies on how to maintain family-centered care during the COVID-19 Pandemic.
Governor Roy Cooper signed into law SL 2020-88 which appropriates funds for the implementation of Medicaid Transformation. SL 2020-88 mandates capitated contracts being by July 1 2021, however, beneficiary enrollment can begin in a phased approach within a 5 month period after July 1.
Centene announced plans to break ground on its East Coast headquarters in Charlotte, North Carolina! Construction will begin in August on a campus that will bring 6,000 new jobs and invest $1 billion in the Charlotte community over time. Carolina Complete Health is part of the Centene Corporation, a diversified, multi-national Fortune 100 healthcare enterprise that focuses on government-sponsored programs for the under-insured and uninsured. Welcome to Charlotte, Centene!
July is Minority Mental Health Awareness Month. “Mental health conditions do not discriminate based on race, color, gender or identity. Anyone can experience the challenges of mental illness regardless of their background. However, background and identity can make access to mental health treatment much more difficult.” – National Alliance on Mental Illness (NAMI).
If your practice would like assistance and training on screening for mental illness please contact your provider engagement coordinator! Carolina Complete Health Network is dedicated to having a robust network of Behavioral Health Providers to support your patients.
NCCARE360 Now in All 100 Counties to Help North Carolina Respond to and Recover from COVID-19. “North Carolina has created the nation’s first statewide technology platform, NCCARE360, to coordinate whole-person care uniting traditional healthcare settings and organizations that address non-medical drivers of health, such as food, housing, transportation, employment and interpersonal safety.” Your CCHN Provider Engagement Coordinator is happy to arrange a practice training with an NCCARE360 Representative. Please contact us for help!
In honor of nurses everywhere, Carolina Complete Health Network put together a brief training offering a few skills from the Community Resiliency Model (CRM). CRM is a set of wellness skills that can help stabilize and reset the nervous system during times of stress. Last fall, Emory University published a study in Nursing Outlook demonstrating how CRM can help to promote nurse well-being. One year after just one 3 hour CRM training, nurses reported great sense of well-being, improved resiliency, and reduced secondary traumatic stress and physical symptoms.
Access Password: Nursesweek2020!