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Division of Medical Assistance |
| Medicaid for North Carolinians |
Health Choice for Children | Medicaid Providers | County Staff | DMA Publications |
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Community Care of North Carolina/Carolina ACCESS Management Reports
In order to assist providers enrolled in Community Care of North Carolina/Carolina ACCESS (CCNC/CA) with managing and coordinating care for their Carolina ACCESS patients, DMA provides four management reports. Primary care providers are strongly encouraged to review these reports each month.
| Report Name | Purpose |
|---|---|
| Monthly Carolina ACCESS Enrollment Report | Provides names and information about the recipients who are newly enrolled, currently enrolled, and no longer enrolled, effective the month the report is received. |
| Monthly Emergency Room Management Report | Provides names, diagnoses, and the cost of care for recipients who went to the emergency room for services. The reason for the visit is divided into emergency diagnoses and non-emergency diagnoses as defined by DMA. The data is based on claims processed during the previous month. |
| Monthly Referral Report | Provides the names of recipients who have seen another medical provider during the previous month. Providers can use this report to see where their patients obtained care and if they authorized the care. This also lets the provider know when an override is approved for services by another provider. |
| Quarterly Utilization Report | Shows providers the utilization and cost of recipients linked to their practice. Information is categorized by PCP office visits, ER/urgent care, pharmacy, hospital inpatient, inpatient and outpatient mental health, specialist referrals, labs, x-rays, and outpatient ambulatory. Information is based on date of payment. Provides comparison with PCP peer group. |
These reports are mailed to each CCNC/CA practice. Providers can also view and download the reports from a confidential website; however, the Provider Confidential and Security Agreement with an original signature must be on file with DMA in order for providers to access the website. Providers may complete and submit the security agreement to DMA. When the security agreement is received, EDS will assign a log-on and password to the practice.
May 2, 2008