Payer Directory

How to check North Carolina Medicaid eligibility

A portal or phone check takes a front-desk staffer 10–15 minutes per patient. A real-time 270/271 check returns plan status, copays, deductibles, and out-of-pocket maximums in seconds.

  • Payer ID NCMCD
  • Real-time 270/271
  • Medicaid

Three ways to verify North Carolina Medicaid coverage

  1. Payer portal — free, but one patient at a time and 10–15 minutes each with logins.
  2. Phone (IVR) — hold times vary; no written record for the chart.
The third way

Automated 270/271 check

Full benefit detail in seconds, batched for your whole schedule — not one patient at a time.

From $0.50 per check, pay-as-you-go.

Payer facts

North Carolina Medicaid at a glance

What billers need before running a check.

  • Payer ID

    NCMCDAlso known as 10156, 12K23, 1561250855, 377

  • Real-time eligibility

    AvailableResponses return in seconds, 24/7.

  • Coverage

    dental, medical, visionMedicaid

  • Operating area

    North Carolina

  • Payer website

    medicaid.ncdhhs.gov
Transactions

Supported transactions

What can be exchanged electronically with North Carolina Medicaid today.

  • Eligibility (270/271)

    SUPPORTEDReal-time benefit and coverage checks

  • Claim status (276/277)

    ENROLLMENT REQUIREDWhere a submitted claim stands

  • Professional claims (837P)

    ENROLLMENT REQUIREDPhysician and outpatient claims

  • Institutional claims (837I)

    ENROLLMENT REQUIREDFacility claims

  • Dental claims (837D)

    ENROLLMENT REQUIREDDental claims

  • Remittance (835 ERA)

    ENROLLMENT REQUIREDElectronic remittance advice

  • Coordination of benefits

    NOT AVAILABLESecondary-payer routing

  • Claim attachments (275)

    NOT AVAILABLESupporting documentation
Compare

Portal vs. phone vs. automated

The same verification, three ways.

MeasurePayer portalPhone / IVRAutomated check
Time per patient10–15 min15–30 minSeconds
Cost per checkStaff time, one login per patient~$8.57 in staff time*from $0.50
Record for the chartScreenshotNoneFull audit trail
Whole-day scheduleOne at a timeOne at a timeBatched overnight

*A manual eligibility check costs a medical practice $8.57; an electronic one costs $2.00. Source: 2024 CAQH Index.

In production

What Medman does in practices today

  • 65%

    fewer denials at Valley Diabetes & Obesity

  • 90%

    of eligibility checks fully automated

  • $107–149K

    annual savings, small specialty practice

  • 24 mo

    in production

Questions

Frequently asked questions

What is the payer ID for North Carolina Medicaid?

North Carolina Medicaid uses payer ID NCMCD. It also appears as 10156, 12K23, 1561250855, 377 in some systems.

Does North Carolina Medicaid support real-time eligibility verification?

Yes. North Carolina Medicaid accepts real-time 270/271 eligibility transactions, so a check returns plan status and benefit detail in seconds instead of the 10–15 minutes a portal login takes.

How long does a North Carolina Medicaid eligibility check take?

A portal check takes 10–15 minutes of staff time per patient. An automated real-time check returns in seconds and can run for an entire day's schedule overnight.

Directory

More payers

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Run your first North Carolina Medicaid eligibility check

From $0.50 per check, pay-as-you-go. No annual contract, no implementation project.

How the eligibility agent worksSee pricing

Billing more than North Carolina Medicaid? — upload it and see which of your payers run automatically.