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Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

Renew by Dec. 15 for Jan. 1 coverage. Stay covered with Ambetter Health.

News

New Policies Effective 8/1/2021

Date: 04/30/21

Dear Provider,

Thank you for your continued partnership with Ambetter of North Carolina, Inc. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of new policies Ambetter of North Carolina, Inc will be implementing effective 8/1/2021. 

Policy NumberPolicy NamePolicy DescriptionLines of Business
CP.MP.208Outpatient Testing for Drugs of Abuse: Presumptive Frequency Edits Medical necessity criteria for presumptive (preliminary) testing for a specific drug and frequency limits for 80305, 80306, and 80307 for chronic opioid therapy. Marketplace


For detailed information about these policies, please refer to our website. And for questions about this or any of our payment policies, please don’t hesitate to reach out to our Provider Services team at (833) 863-1310.

Sincerely,

Ambetter of North Carolina, Inc