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  • Dma-5106pdf Medicaid Pace Program Referral - Info Dhhs State Nc

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MEDICAID REFERRAL PAGE 1 TO: FROM: DATE: I. REQUEST FOR PACE INFORMATION (to be completed and signed by the Medicaid applicant/recipient) I, , have applied/reapplied for Medicaid. I authorize (Print.

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Related content

dhb-5106 Medicaid Pace Program Referral —...
Medicaid Form Number, dhb-5106. Agency/Division, Health Benefits/NC Medicaid (DHB). Form...
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NC Medicaid Direct is North Carolina's health care program for Medicaid beneficiaries who are not enrolled in health plans. It includes care management by Community Care of North Carolina (CCNC), the primary care case management entity (PCCMe) for physical health services.

Starting July 1, 2021, most Medicaid beneficiaries began receiving the same Medicaid services in a new way. Called "NC Medicaid Managed Care," beneficiaries choose a health plan and get care through a health plan's network of doctors.

North Carolina Medicaid includes Baby Love for prenatal and infant health care, Health Check for children up to age 21, Carolina ACCESS for managed care, and community alternatives to provide home and community care as a cost-effective alternative to institutionalization.

NC Medicaid Managed Care Health Plans. Behavioral Health I/DD Tailored Plans. EBCI Tribal Option. Health Plan Contracts.

Medicaid is a health insurance program for low-income individuals and families who cannot afford health care costs. Medicaid may help pay for certain medical expenses including: Doctor Bills.

You or a family member might be eligible if you: Children under age 21. Low-income individuals and families. Adults age 65 or older. Individuals with disabilities.

Contact NC Medicaid Contact Center. Phone: 888-245-0179. Provider Ombudsman. For provider inquiries, concerns, complaints regarding health plans. Medicaid.ProviderOmbudsman@dhhs.nc.gov. Phone: 866-304-7062. NCTracks Call Center. Phone: 800-688-6696.

Click the one called "Medicaid" for Medicaid providers and the one called "Health Choice" for NC Health Choice providers. You need a referral from your Primary Care Provider (PCP) to see a specialist. Only your PCP can refer you to another doctor.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232