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New NC Health Choice physician certification forms in effect(9/10/03) -- There is a new procedure for identifying NC Health Choice special needs children who require services beyond the core benefits package covered by the State Employees Health Plan.Children who need extra, or "wrap-around," services must be certified eligible for these services by their physician. Physicians are asked to complete a Physician Certification stating that a child's condition meets the criteria-- it "lasts indefinitely," "interferes with daily living," and "requires extensive medical intervention and family management." Certification lasts for one year. Physicians will be mailed the forms when they submit a pre-authorization request or a reimbursement claim for a wrap-around service. Parents, physicians, and the public who'd like more information or clarification can call the NC Health Choice Special Needs Helpline at 1-800-737-3028.
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