 Under contract with the Division of Medical Assistance (DMA), Program Integrity (PI) Section, reviews of suspended claims are conducted as part of PI’s instituted process for monitoring and intervening with those providers that continue to demonstrate aberrant billing patterns. Outcomes of CCME’s reviews are reported to PI; PI actions may include exclusion from the Medicaid program if abuse of the Medicaid program continues to be identified or aberrant billing problems persist.
Any provider who bills North Carolina Medicaid may be subject to Prepayment Claims Review.
Have a question for our prepayment claims review staff, email us at claimsreview@thecarolinascenter.org.
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