Frequently Asked Questions

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What are Social Determinants of Health?

Research shows social, environmental, and behavioral factors can influence up to 80% of our health. Conditions including, but not limited to, food insecurity, housing instability, inadequate transportation, and interpersonal violence not only impact our health, safety, and well-being but our use and costs of healthcare.

How do I get involved in Healthy Opportunities of the Piedmont?

  • Attend our upcoming Healthy Opportunities of the Piedmont events.
  • Contact Yolanda Davenport to be added to our e-mail distribution:  ydavenport@ptrc.org or 336-904-0300.
  • Contact Healthy Opportunities of the Piedmont leaders with questions:

What is Medicaid Transformation?

Medicaid Transformation will change the way most people receive Medicaid services. Most Medicaid beneficiaries will transition from the current fee-for-service program managed directly by the state to a managed care plan offered by commercial prepaid health plans (PHPs).

What is NC Medicaid Managed Care?

Under NC Medicaid Managed Care, insurance companies—instead of the state—will assume all risk for the individuals they cover. Under Medicaid Managed Care, beneficiaries can choose from many health plans who will provide them with the same services they receive today and may also offer additional services.

I’m a Medicaid healthcare provider. Whom do I contact with questions about Medicaid Transformation?

Providers must contract with health plans but will still need to enroll as a NC Medicaid or NC Health Choice provider.

  • North Carolina Department of Health and Human Services (NC DHHS) has information for contracting with health plans.
  • For more information, visit the Providers page on the NC Medicaid website.

I’m a Long-Term Care provider. Whom do I contact with questions about Medicaid Transformation?

Contact the Long-Term Care ombudsman for your county. 

I’m a provider of services for those with substance abuse, mental health, or developmental disabilities. Whom should I contact for information about eligibility or claims status?

Contact your Local Management Entity-Managed Care Organization to obtain information regarding eligibility, claims status, or payment.