Community Care of North Carolina/Carolina ACCESS

Community Care of North Carolina/Carolina ACCESS (CCNC/CA) is a primary care case management health care plan for a majority of Medicaid beneficiaries in North Carolina. The program aid category determines if a beneficiary is mandatory, optional or exempted from CCNC/CA.

Participation Requirements of Primary Care Providers (PCPs)

Medical providers interested in serving as a Carolina ACCESS PCP must complete an online application or Managed Change Request through NCTracks.

NCTracks Enrollment

An eligible CCN/CA provider must:

  • Perform primary care that includes certain preventive services
  • Create and maintain a patient/doctor relationship
  • Establish hours of operation for treating patients for at least 30 hours per week
  • Provide access to medical advice and services 24x7
  • Maintain hospital admitting privileges
  • Refer or authorize services to other providers when the service cannot be provided by the PCP
  • Provide oral interpretation for all non-English proficient beneficiaries at no cost

To serve as a PCP in a CCNC/CA network, a provider must first be enrolled with DMA as a Carolina ACCESS PCP. Providers are required to sign a contract with the local network. Contact the regional managed care consultant for more information.

Enrolling Medicaid and NCHC Patients in CCNC/CA

Patients do not have to choose you, the provider, as their health home. If they prefer to choose another provider or do not want to enroll, refer them to their caseworker at the county Department of Social Services (DSS) office.

If a patient is enrolled with another provider but wants to join your practice, ask them to fill out an enrollment form. Medicaid beneficiaries are enrolled in CCNC/CA by the DSS office in the county where they reside.

Exceptions to the Mandatory Program Aid Categories

  • Any Medicaid beneficiary who receives Medicare and Medicaid becomes optional for enrollment
  • Anyone under the age of 21 years who is identified as having special needs becomes optional for enrollment. “Special needs” is defined as any one of:
    • A child receiving SSI
    • A child in foster care or receiving adoption assistance
    • An individual who self-identifies as having special needs
  • Current or potential enrollees who are in the mandatory program aid category can request an exemption from participation for medical reasons. Beneficiaries can request exemption request forms from the county DSS office.

CCNC/CA Referrals

If the CCNC/CA PCP is unable to provide the services, the PCP is then contractually obligated to arrange a medically necessary service referral for the patient to see another practitioner for consultation, or health care treatment.  To refer or authorize a service:

  • The CCNC/CA PCP's service referral must be communicated to the service provider.
  • The PCP defines the scope of a referral , including the number of visits and length of time authorized.
  • The PCP should be informed if a secondary referral (sending patient to a second provider for the same diagnosis), is recommended.
  • A provider who has received a referral should consult with the PCP before referring to a secondary provider.  The PCP may authorize care retroactively (at the discretion of the PCP).

For dates of service prior to Nov. 1, 2016, if a provider has rendered a service and is denied authorization by the PCP, the service provider may request a CA override. To request an override the provider must submit the CA Override Request Form. The forwarding information is on the form. 

Carolina ACCESS Override Request Form

Rules for Providers Billing Beneficiaries

Women, Infant and Children (WIC) Supplemental Nutrition Program

CCNC/CA PCPs are required to refer potentially eligible enrollees to the WIC program. County WIC programs are administered statewide through county health departments, community and rural health centers, and community action agencies.

Provider Forms

CA Provider Participation Agreement

Medicaid CCNC/CA Office Enrollment Guidelines

CA Provider Enrollment Application

Health Check Agreement Between Primary Care Provider and the Local Health Department

CCNC/Carolina ACCESS Member Handbook - English / Spanish

Carolina ACCESS Override Request Form

Regional Managed Care Consultants

Consultants by County

More Information

CCNC/Carolina ACCESS Teaching Tool - 06/01/2016


Network Phone Number
Alamance, Alexander, Alleghany, Ashe, Avery, Burke, Caldwell, Caswell, Catawba, Chatham, Cherokee, Clay, Graham, Haywood, Iredell, Jackson, Macon, Orange, Robeson, Sampson, Swain, Watauga, Wayne


Carolina Collaborative Community Care


Carolina Community Health Partnership
Cleveland, Rutherford


Community Care of the Lower Cape Fear
Bladen, Brunswick, Columbus, New Hanover, Onslow, Pender


Community Care of Wake and Johnston Counties
Johnston, Wake


Community Care of Western North Carolina
Buncombe, Henderson, Madison, McDowell, Mitchell, Polk, Transylvania, Yancey


Community Care Partners of Greater Mecklenburg
Anson, Mecklenburg, Union


Community Care Plan of Eastern Carolina  

Carteret, Craven, Duplin, Jones, Pamlico


Edgecombe, Greene, Lenoir, Pitt


Halifax, Hertford, Nash, Northampton, Wilson


Beaufort, Bertie, Camden, Chowan, Currituck, Dare, Gates, Hyde, Martin, Pasquotank, Perquimans, Tyrrell, Washington


Community Health Partners
Gaston, Lincoln


Northern Piedmont Community Care  



Franklin, Granville, Person, Vance, Warren


Northwest Community Care Network
Davie, Davidson, Forsyth, Stokes, Surry, Wilkes, Yadkin


Partnership for Community Care
Guilford, Randolph and Rockingham


Community Care of the Sandhills
Harnett, Hoke, Lee, Montgomery, Moore, Richmond, Scotland


Community Care of Southern Piedmont
Cabarrus, Rowan, Stanly