I. INTRODUCTION
II. REQUIREMENTS
III. PROCEDURES
IV. FINANCIAL RESPONSIBILITY
Medicaid Procedures for Requesting Corrections – DSS Support Unit
Document Category: Health Benefits/NC Medicaid
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MA-3530 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS
I. INTRODUCTION II. REQUIREMENTS III. PROCEDURES IV. FINANCIAL RESPONSIBILITY Medicaid Procedures for Requesting Corrections – DSS Support Unit
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MA-3535 RECIPIENT FRAUD AND ABUSE POLICY AND PROCEDURES
I. PURPOSE II. LEGAL RESPONSIBILITY AND REFERENCES III. NORTH CAROLINA GENERAL STATUTES IV. FRAUD VS. MISREPRESENTATION V. PREVENTION VI. DETECTION VII. INVESTIGATIONS VIII. CALCULATING OVERPAYMENTS IX. NORTH CAROLINA HEALTH CHOICE OVERPAYMENTS X. CONCLUSIONS AND RECOMMENDATIONS XI. NOTICES & APPEALS XII. ADMINISTRATIVE COLLECTION PROCEDURES XIII. BANKRUPTCY XIV. DISTRIBUTION OF CASH REPAYMENT XV. EPICS REPORTING REQUIREMENTS XVI.…
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MA-3540 MEDICAID COVERED SERVICES
I. INTRODUCTION II. POLICY PRINCIPLES III. PHYSICIAN SERVICES IV. CLINIC SERVICES V. HOSPITAL INPATIENT SERVICES VI. HOSPITAL OUTPATIENT SERVICES VII. NURSING FACILITY SERVICES VIII. PSYCHIATRIC AND PSYCHOLOGICAL SERVICES IX. RESIDENTIAL SERVICES X. MENTAL HEALTH CENTERS XI. STATE AND PRIVATE MENTAL HOSPITALS XII. NORTH CAROLINA SPECIALTY HOSPITALS XIII. DENTAL SERVICES XIV. CHIROPRACTORS XV. PODIATRISTS XVI. HOSPICE…
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MA-3550 NON-EMERGENCY MEDICAL TRANSPORTATION (NEMT)
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MA-3560 2023 – 2024 COUNTY INTERNAL INSPECTION SCHEDULE
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MA-3505 MEDICAID IDENTIFICATION CARD
I. Introduction II. PROCEDURES
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MA-3510 THIRD PARTY RECOVERY
I. POLICY RULES II. PROCEDURES III. TYPES OF THIRD PARTY RESOURCES IV. INTERVIEW QUESTIONS FOR DETERMINING TYPES OF THIRD PARTY RESOURCES V. MEDICAID AS PAYER OF LAST RESORT OR AS PRIMARY PAYER VI. THIRD PARTY RECOVERY NON COMPLIANCE VII. THIRD PARTY INSURANCE FOR NCHC AND BCCM Additions/Terminations/Changes to Third Party Insurance Listserv (August 10, 2020)
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MA-3515 AUTOMATED INQUIRY AND MATCH PROCEDURES
I. INTRODUCTION II. POLICY PRINCIPLES III. MATCHES REQUIRED BY IEVS IV. OTHER MATCHES V. FRR RESOURCE TYPES AND DESCRIPTIONS
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MA-3520 AUTOMATED SOLQ PROCEDURES
I. INTRODUCTION II. BENEFIT VERIFICATION III. MANUAL VERIFICATION OF BENEFITS IV. THE SOLQ/TPQY SYSTEM V. DOCUMENTATION
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MA-3525 MEDICARE ENROLLMENT & BUY-IN
I. INTRODUCTION II. WHO IS ENTITLED TO MEDICARE? III. POLICY PRINCIPLES IV. OVERVIEW OF MEDICARE COVERAGE V. OVERVIEW OF MEDICARE BUY-IN VI. EFFECTIVE DATE OF BUY-IN COVERAGE VII. RECIPIENT ENROLLMENT IN BUY-IN VIII. COUNTY RESPONSIBILITY TO ASSIST WITH MEDICARE APPLICATION IX. CHARGEBACKS FOR COUNTY ERRORS X. PROCEDURES FOR ALIENS XI. INFORMATIONAL MATERIALS SENT TO COUNTIES…