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Instructions for enrolling your Medicaid patients into Community Care of North Carolina/Carolina ACCESS
- Remember: Patients have freedom of choice. They do not have to choose you as their medical home. If they prefer to choose another provider or do not want to enroll, refer them to their caseworker at the department of social services.
- Check the Medicaid card. If the patient is enrolled with another provider, but wishes to join your practice, use an enrollment form to enroll them. Their enrollment will be changed to your practice. The effective date is determined by the date the change is made in the eligibility system.
- Explain the benefits of being a member of Carolina ACCESS.
- A medical home with a primary care provider (PCP). The medical home is a place for well check-ups, sick visits, treatment of special health care needs, etc.
- Medical advice available 24/7. There is no need to go to the ER unless the problem risks life or health without immediate treatment.
- Coordinated medical services so that patients receive necessary care either by the PCP or by a referral to a specialist. The PCP will help find the right specialist.
- Arrangements for hospitalizations when necessary. (Inform patient which hospital PCP admits to.)
- Care management services available through the CCNC/CA network.
- Inform the patient of all services they can get without authorization of the PCP.
- Discuss any office policy. Include circumstances under which a member will be disenrolled.
- Remind them to take their Medicaid card anytime they seek services.]
- Unless they are <21 years old, receive Medicare, or pregnant, they are limited to 24 visits per state fiscal year (July 1 thru June 30). Remind them that they must be responsible for keeping up with their visits. If they exceed 24 visits, they may have to pay for the visit.
- Complete an enrollment form and if possible, have the patient or guardian sign. Mail or fax to the local department of social services.
- Always give your patient a Carolina ACCESS member handbook. This book can be your guide when explaining the benefits and requirements of being a member of Carolina ACCESS. You can order handbooks by contacting the Division of Medical Assistance, Managed Care Section, at 919-647-8179 or faxing a request to the Managed Care Section at 919-715-0844 or 919-715-5235.
May 21, 2008