DHB Auditing Process and NC Medicaid 3136 and 3085 Forms-2025

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NC Medicaid Direct and NC Medicaid Managed Care health plans do not require referrals for specialty care. Some specialists may still require a referral from the to see the patient.
Prepare the following documents below for each person applying to help complete your application: Full legal name. Date of birth. Social Security number (or immigration documents) North Carolina residency. Income information (from paystubs, W-2 forms, tax returns or business records)
An adult ages 19 through 64 may be eligible if the family income is $2,433/month or less. An adult ages 65+ may be eligible for full Medicaid if the family income is $1,763/month or less, and for other programs if the family income is $2,380/month or less.
Division of Health Benefits | NC Medicaid.
The district health board (DHB) system had three predecessors: the Area Health Boards (19831989), the Regional Health Authorities and Crown Health Enterprises (19931997), and the Health Funding Authority (HFA) and Hospital and Health Services (19982001).
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Health plan types Standard Plan. Tailored Plan. Eastern Band of Cherokee Indians (EBCI) Tribal Option. NC Medicaid Direct. Children and Families Specialty Plan.
Prior approval (PA) may be required for some services, products or procedures to verify documentation of medical necessity. Prior approval is for medical approval only and must be obtained before rendering a service, product or procedure that requires prior approval.
NCTracks is used by the Division of Health Benefits (DHB); the Division of Mental Health, Developmental Disabilities, and Substance Use Services (DMH/DD/SUS); and the Division of Public Health (DPH).

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