Managed Care CCNC/CA FAQs

When you are completing an Enrollment, Re-Enrollment, or Managed Change Request (MCR) for an Individual or Organization, you will be given the option to also enroll as a Primary Care Provider (PCP) in the Community Care of North Carolina/Carolina ACCESS (CCNC/CA) program if your provider type qualifies you to participate.
 

NOTE: It is not necessary for individual providers to enroll in CCNC/CA if they are a referring ONLY provider.

Please see this resource: https://www.nctracks.nc.gov/content/public/providers/provider-enrollment/supporting-information/ccncca-eligibility.html

Eligible Community Care of NC/Carolina Access PCPs:

1. Perform primary care services that includes certain preventive & ancillary services
2. Create and maintain a patient/doctor relationship
3. Provide direct patient care a minimum of 30 office hours per week
4. Provide access to medical advice and services twenty-four (24) hours per day, seven (7) days per week
5. Refer to other providers when the service cannot be provided by the PCP
6. Provide oral interpretation for all non-English proficient beneficiaries at no cost

Refer to the job aid on enrolling, updating or terminating CCNC/CA Managed Care Plans (JA_PRV242_Update Terminate CCNC_CA Enrollment) in Skillport. This job aid provides instructions that assist Medicaid providers with enrolling in or terminating participation in Community Care of North Carolina and Carolina ACCESS (CCNC/CA) within NCTracks by completing a Manage Change Request (MCR).

No, effective with date of service November 1, 2016, providers ARE NO LONGER BE REQUIRED to obtain authorization from the PCP of record. You do not need approval from the CCNC/CA PCP to treat a Medicaid beneficiary who presents at your practice.  

No, effective with date of service November 1, 2016, providers are NOT required to enter a NPI as the CCNC/CA payment authorization number for claims processing.

 

Providers should not receive claims denials due to CCNC/CA claims editing effective November 1, 2016.

No, GDIT is no longer accepting requests for CCNC/CA Overrides. If you have a claim that denied due to CCNC/CA, please contact the NCTracks Call Center at 1-800-688-6696.

No, effective May 1, 2017, the NCTracks Provider Portal no longer offers the option to enter CCNC/CA referrals.

Yes, you may treat the enrollee.

Contact the NCTracks Call Center at 1-800-688-6696 for assistance.