Hurricane Helene Disaster Recovery for Providers

The North Carolina Medical Society is working to help our members and others in the health care community rebuild. Please take this survey in order to share the impacts to your provider practice. This information is being shared with the prepaid health plans (PHPs) to assist in provider response.

For a full list of participant conditions for reimbursement eligibility, visit NCDHHS Out-of-State Provider Enrollment webpage for guidelines.

• Disaster Relief Application spotlight on the NCTracks provider page
• Disaster Relief Provider Enrollment and Application Job Aid are located on the NCTracks Provider Enrollment page
• NCTracks OOS User Guides and Fact Sheets webpage.

Border providers render services within 40 miles of the North Carolina border. 

Out-of-state (OOS) providers are located more than 40 miles outside of the borders of North Carolina.

Two types of enrollments:

• Lite Enrollment application, or an abbreviated application, is for a 12-month enrollment period. 
• Full application is for a five-year enrollment period.

Ask to see the member’s plan ID card.

For automated real time eligibility, call ACNC Provider Services at 1-888-738-0004 and follow the prompts for member eligibility.

OR

Access the NaviNet provider portal, a free, web-based application for electronic transactions and information through a secure multi-payer portal.

OR

If a patient presents without a Medicaid ID or their health plan ID card, providers should check NC Medicaid eligibility in NCTracks.

NCTracks Fact Sheet outlines eligibility verification methods.

• If you are unable to submit claims or perform services, financial supports may be available.
• If your practice needs financial support, complete this one-time application no later than December 16, 2024.
• Eligibility criteria is found at the top of the application.
• Payments will be made using the existing payment method you have on file and will be described as “provider stabilization payment” on the remittance advice.
• We encourage you to refer to the North Carolina Department of Health and Human Services (NCDHHS) October 11, 2024, Hurricane Helene Policy Flexibilities to Support Providers and Members bulletin and to keep submitting claims for care rendered to our members.
• Also, please see the Hurricane Helene Provider Practice Impact Surveys.
• Enroll in electronic funds transfer (EFT), using this ECHO Health EFT/ERA Enrollment link to complete your registration. It will be helpful to use information from your first check stub to register. See the Claims and Billing webpage for more information. If you have questions or are experiencing any problems, please contact a Provider Network Management Account Executive for support.

For providers located in counties impacted by the storm, instructions for manually entering your EVV information into the HHAX provider portal are found within the three attachments below. These knowledge-based trainings can aide in this process and are also found in the HHAX portal using the key words search feature. 

• Schedule New Visits (hhaexchange.com) [knowledge.hhaexchange.com]

• Master Week (hhaexchange.com) [knowledge.hhaexchange.com]

• Manually Confirm Visits (hhaexchange.com) [knowledge.hhaexchange.com]

Please reach out to our ancillary team via email with any questions or issues you may encounter.

Providers should contact ACNC Pharmacy Services at 1-866-885-1406 for assistance with prescription flexibility processing during the state of emergency.

• NC Medicaid enrolled pharmacy providers should submit claims with “09” (Emergency Preparedness) in the PA Type Code field to override a denial for prior approval required.

• NC Medicaid enrolled pharmacy providers should submit claims with “09” (Emergency Preparedness) in the PA Type Code field and a valid value for an E.R. override in the Reason for Service, Professional Service, and Result of Service fields to override a denial for an early refill.