Issued: September 25, 2023
As of September 21, 2023, Partners has transferred Medicaid B and Medicaid C authorizations from Alpha+ to ProAuth. New authorizations were created with NC Medicaid Direct B or NC Medicaid Direct C eligibility starting April 1, 2023, through the original approved end date.
What is happening?
- Partners has transferred Medicaid B and Medicaid C authorizations that were created in Alpha+ to ProAuth.
- This applies to Medicaid B and Medicaid C authorizations with end dates on or after April 1, 2023. These authorizations are now end-dated March 31, 2023.
- New NC Medicaid Direct B and NC Medicaid Direct C authorizations for these services were created with a start date of April 1, 2023, running through the original authorized end date.
Why is this happening?
As announced in late July, Partners extended the NC Medicaid Direct flexibilities to ease the administrative burden for providers. This means the flexibilities that went into effect on the launch date for NC Medicaid Direct (April 1, 2023) were extended to September 30, 2023. (Please refer to Provider Alert date July 27, 2023: https://providers.partnersbhm.org/partners-extends-nc-medicaid-direct-flexibilities-to-september-30/)
What is changing for providers?
- Providers will see new authorizations in ProAuth with an end date March 31, 2023.
- Providers will see new authorizations in ProAuth showing NC Medicaid Direct eligibility with a start date of April 1, 2023; the end date will be the original authorization end date.
How does this impact providers?
When the Medicaid Direct Flexibilities end on September 30, 2023, providers will use the authorizations with April 1, 2023, start dates for NC Medicaid Direct claims.
What if providers have questions?
Please contact UMQuestions@partnersbhm.org with any questions related to prior authorization.