Hurricane Helene Disaster Recovery for Providers

This page will be updated with new information as it becomes available.

Member access to care

Please do not turn any Medicaid members/patients away without service or supplies on account of the individual's inability to pay a deductible, co-insurance, or co-payment amount Per NC General Statute 10A NCAC 22J .0106 (e).

Provider Disaster Relief application process

This process is not for providers already enrolled with NC Medicaid and seeing beneficiaries. Due to the natural disaster, NC Medicaid is offering an expedited provider Disaster Relief enrollment application for providers not currently enrolled in NCTracks, to render services to NC Medicaid beneficiaries during the disaster response period.

This Disaster Relief application is available to individuals and organizations that are in-state, on the border, and out-of-state (OOS) providers. Once the provider Disaster Relief application is approved, the enrollment period is set for 180 calendar days from the enrollment effective begin date.

NC Medicaid out-of-state (OOS) provider enrollment information

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.

Verifying member eligibility

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.

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

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.

Provider flexibilities

Due to the Hurricane Helene emergency declaration, ACNC has temporarily suspended provider postal mailings in impacted counties until October 25, 2024.
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 Account Executive for support

Electronic Visit Verification (EVV) providers

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.

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

Pharmacy providers

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.

Providers