Instructions for Medicaid Administrative Claiming (Mac) - Adults and Children Compliance Monitoring Tool - North Carolina

This document was released by North Carolina Department of Health and Human Services and contains the most recent official instructions for Medicaid Administrative Claiming (Mac) - Adults and Children Compliance Monitoring Tool .

FAQ

Q: What is Medicaid Administrative Claiming (MAC)?A: Medicaid Administrative Claiming (MAC) is a process through which Medicaid funds are used to reimburse certain administrative activities related to the provision of healthcare services for Medicaid beneficiaries.

Q: What is the Adults and Children Compliance Monitoring Tool?A: The Adults and Children Compliance Monitoring Tool is a tool used in North Carolina to ensure compliance with Medicaid Administrative Claiming (MAC) requirements for both adults and children.

Q: What is the purpose of the compliance monitoring tool?A: The purpose of the compliance monitoring tool is to ensure that Medicaid Administrative Claiming (MAC) activities are conducted in accordance with applicable regulations and guidelines.

Q: Who uses the compliance monitoring tool?A: The compliance monitoring tool is used by individuals and organizations responsible for overseeing and monitoring Medicaid Administrative Claiming (MAC) activities in North Carolina.

Q: What activities does Medicaid Administrative Claiming (MAC) reimburse?A: Medicaid Administrative Claiming (MAC) can reimburse activities such as case management, transportation coordination, and targeted case management services.

Q: Why is compliance monitoring important for Medicaid Administrative Claiming (MAC)?A: Compliance monitoring is important to ensure that Medicaid funds are used appropriately and that the administrative activities are being performed in compliance with regulations and guidelines.

Q: What happens if non-compliance is identified through the monitoring tool?A: If non-compliance is identified through the monitoring tool, corrective action may be required, such as additional training or changes to administrative processes.

Q: How often is the compliance monitoring tool used?A: The compliance monitoring tool is used on an ongoing basis to monitor and assess compliance with Medicaid Administrative Claiming (MAC) requirements.

Q: Who can I contact for more information about the compliance monitoring tool?A: For more information about the compliance monitoring tool, you can contact the North Carolina Medicaid program or your local Medicaid administrative agency.