Clarification re: Carolina ACCESS Referrals

Claims submitted for a recipient and procedure that require Carolina ACCESS referral should have a Carolina ACCESS referral number. However, State policy currently allows providers to use the National Provider Identifier (NPI) of the recipient's Carolina ACCESS Primary Care Physician (PCP) on the claim, in place of a Carolina ACCESS referral number. NCTracks will accept a Carolina ACCESS referral number, but it is not mandatory.

The State will communicate with the provider community before the mandatory implementation of the Carolina ACCESS referral number goes into effect. In the meantime, providers can continue to use the National Provider Identifier (NPI) of the recipient's Carolina ACCESS Primary Care Physician (PCP) on the claim, in place of a Carolina ACCESS referral number.