Patient Management Tools
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Medicaid tools and information

Useful information for health care providers

The following links and documents provide detailed information on Medicaid policies and programs.

Overview:  If you are new to NC's Medicaid program, please start with this overview.

Medicaid sign up:  Health care providers who have not yet signed up to participate in the NC Medicaid program should go here.

Billing Guide: For the best overall guide, please go to the Basic Medicaid and Health Choice Billing Guide.  This is a long but readable summary of the program.   You can read the entire manual or just click on the chapters that you find relevant.  If you have read this before, just click on the "Summary of Changes."  The Guide is updated in October and April of each year.

Medicaid Resource Guide 2012: An online guide to Medicaid resources for CCNC Care Managers, including links to Medicaid policies and procedures.

Bulletins: providers are strongly encouraged to bookmark the Medicaid Bulletins page to keep apprised of policy and coding changes. You may also find it helpful to subscribe to Medicaid email alerts.

Consumer Guides:  there is also a wealth of information available in the Medicaid Consumer Guides. (Scroll down just below the Consumer Notices.) Information is separated by population served by the program (e.g., women and children, Aged, Blind and Disabled, etc.)

Preferred Drugs: please see the Multipayer Drugs of Choice List (DOC), available via a link on CCNC's Provider Portal log-in page. (no ID or password required).  The DOC link will also take you to North Carolina's Preferred Drug List (PDL).

Misuse of Services:  If you think that you have information on improper activities, please help protect the integrity of the Medicaid program by using this online form to report suspected misuse of services.You may also ask your practice's CCNC care manager to make a "Clinical Integrity" report to the CCNC central office.