North Carolina Medicaid: Avoid claim denials
Claims that are missing required transition of care prior authorizations will be denied.
This serves as a reminder that all UnitedHealthcare Community Plan members require prior authorization approval for transition of care (TOC) from another Prepaid Health Plan (PHP). The PHP or the North Carolina Department of Health and Human Services (DHHS) must provide record of approval before the member receives services.
Claims that are submitted without an approved prior authorization will be denied.
What you need to do
If a member is receiving services without a TOC prior authorization, reach out to the case management team for retroactive approval using one of the methods below:
| Call | Fax | |
|---|---|---|
Email nchpcm@uhc.com and include a copy of the previously approved prior authorization with the following information:
|
Call 855-873-2372 and provide them with the following information:
|
Fax 855-541-8921 and include a copy of the previously approved prior authorization with the following information:
|
Questions? We're here to help.
Connect with us through chat 24/7 in the UnitedHealthcare Provider Portal. For additional contact information, visit our Contact us page.
PCA-1-23-04012-POE-NN_12212023
