Outreach and education for transition

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(11/05) --

Family Outreach

Families impacted by the transition will receive several mailings:

• An "Approval Notice" for transition of children birth through 5 from NCHC to Medicaid will be mailed December 5, 2005. An extended message explains the transition in English. A Spanish sentence notifies families that a bilingual letter explaining the content of the notice will follow.
  
• A bilingual letter will be sent the week of December 12-16, 2005 that will fully explain the transition.
  
• In both mailings, questions from families are being directed to their local department of social services or the CARE-LINE (who can "bridge" calls to DMA staff as appropriate).
  
• For children being transitioned, new Medicaid cards will arrive the beginning of January 2006.
  
• The booklet, "A Consumer's Guide to North Carolina Medicaid: Health Insurance Programs for Families and Children", which provides benefits information, will also be mailed in early January. A Health Check/EPSDT flyer will also be mailed with the consumer handbook.

As families receive notices and letters, help them understand the transition. Reassure them that both Health Check and NC Health Choice are comprehensive child health insurance programs. Assure them that their child will be continuously insured through the transition and that they will not need to re-enroll until the date currently noted on their NC Health Choice card.

Provider Outreach

An article, "North Carolina Health Choice Children Age 0-5 Moving to Medicaid", was published in the November 2005 General Medicaid Bulletin (page 5). In addition:

• A Special Medicaid Provider Bulletin is being written by DMA to explain the transition of children birth through 5 and how it will work. This bulletin will be published in early December. The bulletin will address issues that providers need to understand in relation to the transition including Eligibility, Managed Care, Prior Approval, and Hospital Coverage. The Monthly General Medicaid Provider Bulletins over the next several months will refer providers to the Special Bulletin.
  
• DMA and DPH plan to send list serve messages to a long list of provider groups informing them of the change and hyper-linking them to the Special Medicaid Provider Bulletin. The State Employees Health Plan will notify their NC Health Choice Providers as well.
  
• Remittance Advice Banner Messages regarding the change and alerting providers to watch for the Special Bulletin will be sent out.
  
• Health Check Coordinators; Child Service Coordinators; Infant Toddler Specialists, Community Care of North Carolina Staff, Child Care Health Consultants and other outreach / care coordination staff will be targeted for information.

Other Issues / Concerns Especially Relevant to Children with Special Health Care Needs

There are other concerns that are especially relevant to families who have children with special health care needs:

• The transition may require a change in the child's primary care provider, dentist, or specialty provider if their current providers do not accept Medicaid.
  
• There are Prior Approval Issues that must be managed through the transition from NCHC to Medicaid. The Special Bulletin will address prior approval issues.
  
• For children who are hospitalized during the transition period, if they are admitted prior to January 1, 2006, NC Health Choice will pay the hospital bill.
  
• Physicians will no longer be required to submit a Physician Certification Form for children with special health care needs under 6 years old.