Patient Administration

We realize that you perform administrative tasks in addition to tasks directly related to patient care.

To assist you with these tasks, we’ve consolidated the information below.

Member Grace Period

Members have a federally mandated 90-day grace period if they are receiving advance premium tax credit (APTC), or a 31-day grace period if they are not receiving APTC in which to make their payment. The ATC is not applicable for members’ initial payment. For APTC-receiving members, CareSource of North Carolina Co.® will flag the member in the eligibility file on the Provider Portal and suspend pharmacy benefits/claims 30 days after the due date. For non-APTC members, CareSource of North Carolina Co. will proceed with flagging the member the day after their due date.

If the member brings their account into good standing before the expiration of the grace period, pharmacy benefits will start again and pended claims will be processed.

Member Rights & Responsibilities

As a CareSource of North Carolina Co. provider, you are required to respect the rights of our members. CareSource of North Carolina Co. members are informed of their rights and responsibilities via their member handbook. Please review our members’ rights and responsibilities and ensure your practice is in compliance.