108D-55. Administrative functions.
PHPs shall be responsible for all administrative functions for recipients enrolled in their plan, including, but not limited to, claims processing, care and case management, grievances and appeals, and other necessary administrative services. (2015-245, s. 4; 2019-81, s. 14(a).)
Structure North Carolina General Statutes
North Carolina General Statutes
Chapter 108D - Medicaid and NC Health Choice Managed Care Programs
Article 4 - Prepaid Health Plans.
§ 108D-30 - (Effective until contingency met see note) Intent and Goals.
§ 108D-35 - (Effective until contingency met see note) Services covered by PHPs.
§ 108D-40 - (Effective until contingency met see note) Populations covered by PHPs.
§ 108D-45 - (Effective until contingency met see note) Number and nature of capitated PHP contracts.
§ 108D-50 - Defined measures and goals.
§ 108D-55 - Administrative functions.
§ 108D-60 - BH IDD tailored plans.
§ 108D-65 - (Effective until contingency met see note) Role of the Department.