Managed Care Health Plan Contacts and Resources:

Prompt Payment Fact Sheet:

NC Medicaid Managed Care Billing with Barnestorm

NC Medicaid MCOs accept a standard electronic837, which is what Barnestorm creates. Therefore, the process of creating claims for each MCO is exactly the same in Barnestorm as creating a claim for Medicaid. However, the method of transmitting the electronic claim to each MCO varies per organization. This document is a reference list of how to upload claims for each MCO. Bear in mind that some allow more than one way to upload.

Guidelines for submission for all MCOs require that the claim must be submitted within 180 days of the date of service.

IMPORTANT: It is the provider’s responsibility to communicate with the MCOs as needed to set up your portal with them, adjudicate claims, etc. Barnestorm is not an intermediary or a billing agent.

·   Requires 4ICD codes on claim.

·   Goes through Change Healthcare for batch electronic claims submission.

·   If you have a Change Healthcare account, call them at 1-877-363-3666 to inform them you wish to initiate electronic claim submissions to AmeriHealth Caritas North Carolina. EDI Payer ID#: 81671

·   If you do not have a Change Healthcare account, Barnestorm can provide access for you(monthly fee applies).

·   Upload claims through their portal, https://www.availity.com/provider-portal

·   Or upload through Change Healthcare for batch electronic claims submission.

·   If you have a Change Healthcare account, call them at 1-877-363-3666 to inform them you wish to initiate electronic claim submissions to BCBS of NC.

·   If you do not have a Change Healthcare account, Barnestorm can provide access for you(monthly fee applies).

·   Goes through Change Healthcare for batch electronic claims submission.

·   If you have a Change Healthcare account, call them at 1-877-363-3666 to inform them you wish to initiate electronic claim submissions to Carolina Complete Health.EDI Payer ID#: 68069

·   If you do not have a Change Healthcare account, Barnestorm can provide access for you(monthly fee applies).

·   Goes through Change Healthcare for batch electronic claims submission.

·   If you have a Change Healthcare account, call them at 1-877-363-3666 to inform them you wish to initiate electronic claim submissions to United Healthcare of  North Carolina. EDI Payer ID#: 87726

·   If you do not have a Change Healthcare account, Barnestorm can provide access for you(monthly fee applies).

·   Upload claims through their portal, https://provider.wellcare.com/

·   Or upload through Change Healthcare for batch electronic claims submission.

·   If you have a Change Healthcare account, call them at 1-877-363-3666 to inform them you wish to initiate electronic claim submissions to Wellcare of North Carolina. EDI Payer ID#: 14163

·   If you do not have a Change Healthcare account, Barnestorm can provide access for you(monthly fee applies).

·   No electronic claims information provided by MCO (unknown)