Out of State Provider Enrollment

[Article reprinted from the August 2017 Medicaid Bulletin]

Effective October 29, 2017, Out of State (OOS) providers who are seeking to enroll with N.C. Medicaid or the Children’s Health Insurance Program (CHIP) – also known as N.C. Health Choice (NCHC) – will have the option to enroll using a full-enrollment application or a lite enrollment application.

If an out of state provider chooses to enroll using the lite-enrollment application the following will apply: ï‚·

• The provider will complete an abbreviated application. ï‚·
• Enrollment is limited to one year. ï‚·
• Credentialing and background checks will be required including fingerprinting. if applicable. ï‚·
• There is no application fee for lite-enrollment.

If an out of state provider chooses to enroll using the full-enrollment application the following will apply: ï‚·

• The provider will complete a full-enrollment application. ï‚·
• The provider is required to complete re-verification every five years. ï‚·
• Credentialing and background checks will be required including fingerprinting, if applicable. ï‚·
• The provider will be required to pay the $100 N.C. application fee during enrollment and re-verification.

Note: A provider has the option to change from lite enrollment to full enrollment by submitting a Manage Change Request (MCR). The provider will be required to pay the $100 N.C. application fee.