The North Carolina Department of Health and Human Services (DHHS) and prepaid health plans (PHPs) are committed to supporting providers during the transition to managed care. They stand by the Day One goal to ensure providers are paid for services they provide. DHHS and PHPs are aware of potentially delayed payments and increased claim denials during the transition period.
Providers experiencing claim payment issues should initially work with the PHPs to address claim issues and avoid the need for a hardship advance. Refer to the Guidance for Providers Experiencing Payment Issues bulletin for contact information.
As DHHS, PHPs and providers address the various claim processing problems, providers who are at risk of not meeting financial obligations this month as a result of claim processing issues may request a hardship advance to offset the business cost due to pended or denied claims.
Thank you for your patience and cooperation as they work to resolve managed care transition claim issues. For more information, please see the Medicaid bulletin Expedited Hardship Advances for Managed Care Providers.
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