Information for Providers
From NCDHHS; Tailored Care Management Provider Manual (August 29, 2022)
This document was updated on August 29, 2022 to reflect updates related to care manager and supervising care manager qualifications, extender supervision requirements, and data security. Any questions about Tailored Care Management should be submitted to: Medicaid.TailoredCareMgmt@dhhs.nc.gov.
Providers are invited to ask questions from Trillium related to Medicaid Transformation. Our goal is to help providers find answers and resources to help during this transition. Once we have started receiving questions, we will post “Frequently Asked Questions” on this page.
We will be in touch with our provider network (new and existing) over the next year to share about training opportunities, changes to our processes, and organizational updates. Please be sure to sign up to receive Network Communications Bulletins. Our special “Medicaid Transformation Updates” share specific information during this process.
Tailored Plan Provider Quick Reference Guide
See more information below:
Providers are invited to ask questions from Trillium related to Medicaid Transformation. Our goal is to help providers find answers and resources to help during this transition.
We will be in touch with our provider network (new and existing) over the next year to share about training opportunities, changes to our processes, and organizational updates. Please be sure to sign up to receive Network Communications Bulletins. Our special “Medicaid Transformation Updates” share specific information during this process.
Working together through Medicaid transformation:
If you have questions for NC DHHS or the Provider Ombudsman, you can email them at:
INFORMATION FOR PROVIDERS
Key Dates for Tailored Plan launch
- June 15, 2022 – Tailored Plan marketing can begin; Enrollment Broker to start updating provider directory to include Tailored Plan providers
- July 16, 2022 – Last day for providers to have fully executed contracts with PHPs for inclusion in the first day of the beneficiary choice period
- August 1, 2022 – Beneficiaries will be assessed to confirm qualification for Tailored Plan. Beneficiaries that no longer qualify will receive a notice from the Enrollment Broker about their choices
- August 15, 2022 – Beneficiary Choice Period begins; Beneficiaries can choose a Primary Care Provider (PCP) by contacting their Tailored Plan
- August 15, 2022 – Tailored Plan Auto-Enrollment begins. Enrollment Broker begins mailing Enrollment Packets to beneficiaries
- September 15, 2022 – Last day for PCPs to have fully executed contracts with PHPs for inclusion in PCP Auto Assignment
- September 30, 2022 – Last day for Tailored Care Management providers to have fully executed contracts with PHPs for inclusion in Tailored Care Management Auto-Assignment
- October 14, 2022 – Last day for beneficiaries to choose a PCP before PCP auto-assignment
- October 15, 2022 – PCP Auto-Assignment (by Tailored Plan) for beneficiaries who have not chosen a PCP
- January 5, 2023 – Last day for providers to have fully executed contracts with Tailored Plans for inclusion in the first day of the beneficiary choice period.
- January 15, 2023 – Tailored Plan auto-enrollment and Beneficiary Choice Period begin. Beneficiaries can choose a PCP by contacting their Tailored Plan.
- January 15, 2023 – Last day for PCPs to have fully executed contracts with Tailored Plans for inclusion in PCP auto-assignment.
- January 23, 2023 – Enrollment Broker begins mailing Tailored Plan Enrollment Packets to beneficiaries.
- February 14, 2023 – Last day for beneficiaries to choose a PCP before auto-assignment.
- Post February 15, 2023 – PCP auto-assignment for beneficiaries who have not chosen a PCP.
- October 1, 2023 – Tailored Plan launch.
The NC Medicaid Enrollment Broker webpage is now live. This new information will help members in selecting a health plan if they are placed on the Standard Plan.
Medicaid Transformation Information
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