Claims and Billing

For the Carolina Complete Health Billing Manual, visit Manuals, Forms, and Guides

Reminder:  Taxonomy Accuracy and Inclusion on EDI claims

Please verify that the Rendering Taxonomy, Billing Taxonomy, and Attending Taxonomy (for institutional claims) are completed fields and align with what is in NCTracks. For further assistance, please reach out to your Provider Engagement Coordinator or the Provider Relations and Support Team. 

To view our Claims Submission Reminder Guide, please visit Manuals, Forms, and Guides.

Announcements

9/22/21: Revised Medical Claims Payment Schedule

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.

Provider Claims Payment Schedule

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.

Claim Type

First Claims Payment

First Claims DOS

Future Forward

Envolve Vision

July 8, 2021

July 1 – 7, 2021

Weekly,  Wednesday

NIA

July 13, 2021

July 1 – 9, 2021

Weekly, Tuesday and Friday

Medical

July 13, 2021

July 1 – 9, 2021

Weekly, Monday and Thursday

Pharmacy

July 14, 2021

July 1 – 7, 2021

Weekly,  Wednesday

Payspan

Payspan: A Faster, Easier Way to Get Paid (PDF)

  • If you are brand new to Payspan, there are additional validation steps required to complete the registration with Payspan. Please contact your Provider Engagement Coordinator or our Provider Relations and Support Team if you have any difficulty  during this process and we will be happy to help as much as possible. 
  • To contact Payspan: Call 1-877-331-7154, Option 1 – Monday thru Friday 8:00 am to 8:00 pm est.
  • Payspan offers monthly training sessions for providers covering the following topics:
    • How to Register with Payspan (New User)
    • How to Add Additional Registration Codes to an Existing Payspan Account
    • How to navigate through the Payspan web portal
    • How to view a payment
    • How to find a remit
    • How to change bank account information
    • How to add new users
  • 2021 Scheduled Payspan Provider Portal Webinars (3rd Wednesday of each month)

Definitions

Paid in Full - The claim has been adjudicated, processed and reimbursed in accordance and with the executed provider contract on file including the coordination of benefits, as applicable per claim.

Office Hours Registration

CCH Claims Office Hours Support

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