Get the free Basic Medicaid and NC Health Choice Dental Claims - ncdhhs

This document serves as a guide for dental providers on billing and claims submission procedures for North Carolina Medicaid and NC Health Choice. It includes details about electronic claims requirements,

How to fill out basic medicaid and nc

How to fill out Basic Medicaid and NC Health Choice Dental Claims

1. Gather all necessary documents, including patient information, insurance details, and dental procedure codes.
2. Complete the provider information section with your name, address, and provider number.
3. Fill out the patient information section, including the patient’s full name, Medicaid ID number, and date of birth.
4. In the service details section, list the dental procedures performed, including procedure codes and descriptions.
5. Indicate the date of service and the total amount charged for each procedure.
6. Include any necessary attachments such as X-rays or dental referrals.
7. Review the claim for accuracy and ensure that all required fields are completed.
8. Submit the claim electronically or by mail to the appropriate Medicaid and NC Health Choice address.

Who needs Basic Medicaid and NC Health Choice Dental Claims?

1. Individuals who qualify based on income and family size for low-income health coverage.
2. Families with children who need dental care but have limited financial resources.
3. Children under age 19 who are eligible for NC Health Choice and require dental services.

People Also Ask about

Is NC Medicaid Direct the same as Medicaid?

NC Medicaid Direct is North Carolina's health care program for NC Medicaid beneficiaries who are not enrolled in NC Medicaid Managed Care. It includes care management by Community Care of North Carolina (CCNC), the primary care case management entity for physical health services.

What are the four types of Medicaid?

There are four types of Medicaid delivery systems: State-operated fee-for-service (FFS) Primary care case management (PCCM) Comprehensive risk-based managed care (MCO model) Limited-benefit plans.

What is NC Medicaid called now?

North Carolina's Transformation to NC Medicaid Managed Care On July 1, 2021, most Medicaid beneficiaries began receiving the same Medicaid services under NC Medicaid Managed Care. With managed care, beneficiaries choose a health plan and get care through the health plan's network of doctors.

What is the Medicaid program called in NC?

Medicaid Managed Care: The largest NC Medicaid program. People join one of several available standard health plans, officially known as prepaid health plans, or PHPs. Four PHPs are available in all the N.C. counties (with one additional plan also available in a few of the southernmost counties that Access East serves).

Why doesn't Medicaid cover dental for adults?

Dentists may not accept Medicaid for several reasons: Low Reimbursement Rates: Medicaid typically pays lower reimbursement rates compared to private insurance. This can make it financially challenging for dental practices to cover their costs, including overhead, staff salaries, and materials.

What does Medicaid cover for dental for adults in NC?

NC Medicaid Dental Coverage for Adults Generally, you can receive exams, cleanings, fillings, sealants, x-rays, extractions, and dentures. Surgeries and periodontal services are available when medically necessary, and root canals are available for those under 21.

Will Medicaid pay for dental implants in NC?

Medicaid will NOT pay for the following dental services: Dental implants • Permanent bridgework (except for cleft palate cases) • Same-day full or partial dentures • Molar root canal therapy to fix infections (there are exceptions) • Crown lengthening to help fix a tooth • Replacement of partial or full dentures before

What is the difference between NC Medicaid and NC Medicaid Direct?

NC Medicaid Direct is North Carolina's health care program for NC Medicaid beneficiaries who are not enrolled in NC Medicaid Managed Care. It includes care management by Community Care of North Carolina (CCNC), the primary care case management entity for physical health services.

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What is Basic Medicaid and NC Health Choice Dental Claims?

Basic Medicaid and NC Health Choice Dental Claims are forms used to request reimbursement for dental services provided to eligible individuals enrolled in North Carolina's Medicaid and Health Choice programs.

Who is required to file Basic Medicaid and NC Health Choice Dental Claims?

Dental providers who deliver services to patients enrolled in Basic Medicaid or NC Health Choice are required to file these claims to receive payment for their services.

How to fill out Basic Medicaid and NC Health Choice Dental Claims?

To fill out Basic Medicaid and NC Health Choice Dental Claims, providers must complete the designated claim form, including patient information, provider details, procedure codes, and any necessary documentation to support the claim.

What is the purpose of Basic Medicaid and NC Health Choice Dental Claims?

The purpose of Basic Medicaid and NC Health Choice Dental Claims is to facilitate the reimbursement process for dental services rendered to eligible individuals, ensuring that providers are compensated for their care.

What information must be reported on Basic Medicaid and NC Health Choice Dental Claims?

Basic Medicaid and NC Health Choice Dental Claims must include the patient's Medicaid number, date of service, procedure codes, provider information, and any additional documentation required by the payer.