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We are committed to providing comprehensive information through this provider manual as it relates to carolina complete health operations, benefits, and policies and procedures See reverse side for instructions. This provider manual is posted on the carolina complete health website where it can be reviewed and printed free of charge.

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Following each species’ state listing in this document are the species’ federal listing, as designated by the u.s The beneficiary must be medicaid eligible and a carolina complete health member on the date of service Fish and wildlife service, (if applicable)

Federal designations and their definitions are listed below

These grades and scales are maintained by the state boad of education (sbe). You have the right to name someone to make health care decisions for you when you cannot make or communicate those decisions This form may be used to create a health care power of attorney, and meets the requirements of north carolina law However, you are not required to use this form, and north carolina law allows the use of other forms that meet certain requirements

Prior authorization request authorization approves the medical necessity of the requested service only It does not guarantee payment, nor does it guarantee that the amount billed will be the amount reimbursed