North Carolina Medicaid
North Carolina Medicaid is a Medicaid managed-care plan operating in North Carolina. For an ASC, what matters isn't the logo. It's how North Carolina Medicaid pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete North Carolina Medicaid analysis
Tell us where to send it. Our team will prepare an analysis of North Carolina Medicaid covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How North Carolina Medicaid pays
See how North Carolina Medicaid reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
North Carolina Medicaid's presence spans North Carolina. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for North Carolina Medicaid and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive North Carolina Medicaid's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking North Carolina Medicaid up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with North Carolina Medicaid
- Payer ID
- NCMCD is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to North Carolina Medicaid through a clearinghouse.
- Eligibility verification
- Coverage and benefits for North Carolina Medicaid members are verified before the date of service, through a clearinghouse using payer ID NCMCDor through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with North Carolina Medicaid directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of North Carolina Medicaid the way it pays.
- What is North Carolina Medicaid's payer ID?
- North Carolina Medicaid's electronic payer ID is NCMCD. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to North Carolina Medicaid through a clearinghouse.
- How do ASCs verify eligibility for North Carolina Medicaid members?
- Eligibility and benefits for North Carolina Medicaid members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID NCMCD) or through the payer's provider portal.
- Does North Carolina Medicaid require prior authorization for ASC procedures?
- Prior-authorization requirements for North Carolina Medicaid are set per plan and per procedure. Confirm whether an authorization is required with North Carolina Medicaid directly before the date of service.
- What type of payer is North Carolina Medicaid?
- North Carolina Medicaid is a Medicaid managed-care plan operating in North Carolina.
- How does North Carolina Medicaid compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where North Carolina Medicaid pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is North Carolina Medicaid paying my ASC below market?
- Put your own North Carolina Medicaid contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.