General Category > New!

NC medicaid

<< < (2/2)

Pay_My_Claims:

--- Quote from: PMRNC on September 30, 2009, 09:14:26 AM ---I'm a tad confused unless this provider pars with CA but not Medicaid...but it might still be Moot


--- Quote ---but if the patient is not CA, just straight medicaid, you have to use a CA participating psychiatrist or LME for a referral These charges were incurred without getting a referral.
--- End quote ---

In most states Medicaid requires pre-authorization, if there are NO other Medicaid providers in a given area they may give a pre-approval but it has to be done BEFORE the visit as they won't give retro referals/Auths

--- End quote ---

there is a difference between a CA Medicaid Provider and a Medicaid Provider. You can enroll in the NC Medicaid program, and you can also become a CA Provider...which means you are a NC Medicaid Provider but also CA (carolina access). You can't part with Carolina Access unless you are a NC Medicaid provider. thats impossible.

Pay_My_Claims:

--- Quote from: rachel on September 30, 2009, 11:48:35 AM ---I am not sure if your situation would qualify but I was advised that there is a way to override and get a claim submitted. You go to the DMA website under Providers, then to Community Care of NC, in the list is the CA Override Request, fill out and fax.  I personally have not utilized this form so I have no other info to provide...sorry...good luck...Let me know how it works out!  Hope this helps!

--- End quote ---

YES you can get a CA override, but that is generally in situations where the patient needs emergent care and or the PCP refuses to give you the CA# because of some bogus reasons. If the patient never saw his PCP or wasn't referred by a NC Medicaid Provider prior to this visit. they are more than likely SOL, but it can never hurt to try to get the override.

Navigation

[0] Message Index

[*] Previous page