NC Health Choice (North Carolina’s CHIP program) Is Moving to Medicaid.

March 28, 2023, Provider Notice

On April 1, 2023, approximately 55,000 children (ages 6 – 18) who have been enrolled in NC Health Choice will move to Medicaid. Beneficiaries moving from NC Health Choice to Medicaid will be eligible to receive additional benefits, including:

• Early and Periodic Screening, Diagnostic and Treatment (EPSDT) to discover and treat childhood health conditions before they become serious.
• Assistance getting to and from Medicaid-covered services through non-emergency medical transportation (NEMT) services.
• Prenatal care, childbirth, and postpartum care.
• No enrollment fees or copays. (See NCDHHS post: Cost-Sharing Implications of NC Health Choice Move to Medicaid MONDAY, JANUARY 30, 2023.)

Members affected by the change have received new member ID cards. There will no longer be an NC Health Choice identifier at the top of the card. All ACNC member ID cards will be the same (see photo). Note: Members’ Medicaid ID and AmeriHealth Caritas North Carolina ID numbers have not changed.

NC Health Choice to Medicaid: Claims and Billing

• ACNC will follow published NC Health Choice billing guidance for NC Health Choice services rendered before April 1, 2023. New claims for services rendered on or after April 1, 2023, for former NC Health Choice beneficiaries will be billed per the General Medicaid portion of the Medicaid Billing Guide.
• ACNC will follow existing claim-filing deadlines and payment timelines as outlined in our Claims and Billing manual, found on our website.
• Existing authorizations will remain with the member record and will not need to be resubmitted even after the benefit category is changed.