North Carolina has over 350 Medicare-certified HHAs. The state launched Medicaid Managed Care in 2023 with Standard Plans (Healthy Blue, AmeriHealth Caritas, UnitedHealthcare, WellCare) and Behavioral Health I/DD Tailored Plans across 6 regions. This transition created new eligibility complexity for home health agencies statewide. ClientCare monitors every patient's coverage and screens your staff against the OIG/LEIE automatically.
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350+
Medicare-certified NC HHAs
6
Managed care regions
$34K
Average annual loss per agency
North Carolina transitioned from fee-for-service to managed care in 2023. The shift to Standard Plans and Tailored Plans created new enrollment, redetermination, and coverage verification workflows that agencies are still adapting to.
NC Medicaid now has two tracks: Standard Plans for most beneficiaries and Behavioral Health I/DD Tailored Plans for complex populations. Home health agencies must verify which plan type each patient belongs to — billing the wrong plan results in denial.
North Carolina divided the state into 6 regions for managed care rollout. Each region has different plan availability, and patients moving between regions may need to switch plans — creating coverage gaps during transitions.
Eligibility monitoring and compliance screening purpose-built for the North Carolina home health market — from Charlotte to the Outer Banks.
ClientCare checks every North Carolina patient’s Medicaid and Medicare status on a rolling basis — across Healthy Blue, AmeriHealth Caritas, UnitedHealthcare, and WellCare plans. Know before the next visit, not after the denial.
Every staff member is screened against the federal exclusion list every month. 100% of your North Carolina workforce, zero sampling, fully automated.
Get notified the moment a patient’s eligibility changes across any NC Standard Plan or Tailored Plan. Plain-English alerts tell you which patient, which payer, and what to do next.
Export your roster from WellSky, Axxess, AxisCare, or any system used by North Carolina agencies. Upload the CSV and screening starts automatically — no special formatting required.
Pull patient and staff CSVs from WellSky, Axxess, AxisCare, or any EMR used by your North Carolina agency. No special formatting required.
Drag and drop your files. Our system maps columns automatically, starts eligibility checks across all NC Standard Plans and Tailored Plans, and screens staff against the OIG/LEIE.
ClientCare monitors eligibility on a rolling basis across NC Standard Plans, Tailored Plans, and Medicare. You get alerts the moment coverage changes — not after a denial stacks up.
We also serve home health agencies in: