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Targeted Case Management New CAP/Targeted Case Management (CTC) Form for MR/DD Submissions to Valuations A new CAP/Targeted Case Management (CTC) request for authorization form has been approved and
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Start by gathering all the necessary information and documents required for the utilization form.
02
Fill in your personal details, such as your name, address, contact information, and any other required identification information.
03
Provide details about your current health condition and the services you are receiving or wish to receive from the North Carolina Division of Medical Assistance (DMA) or Local Management Entities (LMEs).
04
Answer any specific questions regarding your eligibility for the programs and services offered by DMA and LMEs.
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Provide any additional information or documentation required to support your application, such as medical reports or statements from healthcare providers.
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Who needs nc dma lme utilization:

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Individuals who are seeking medical assistance and services through the North Carolina Division of Medical Assistance (DMA) or Local Management Entities (LMEs).
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Those who are eligible for Medicaid or other healthcare programs provided by the DMA and LMEs.
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Individuals with specific healthcare needs who require coordination and access to services and supports provided by the DMA and LMEs.
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