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Get Nc Medicaid Carolina Access Override Request Form

Carolina ACCESS Override Request Form Complete this form to request a Carolina ACCESS override when you have received a denial for EOB 270 or 286 or the Primary Care Provider PCP has refused to authorize treatment for past date s of service. The request must be submitted within six months of the date of service. Overrides will not be considered unless the PCP has been contacted and refused to authorized treatment. Attach any supporting documentat.

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