Medcost INCLUSIVE HEALTH

Medcost contracts with Inclusive Health

Inclusive Health, also known as the North Carolina Health Insurance Risk Pool (NCHIRP), has contracted with MedCost to use their provider network. As the chiropractic network for MedCost, CNC providers will participate with Inclusive Health.

What is Inclusive Health?

In 2007, the North Carolina General Assembly passed Session Law 2007-0532, which created the NCHIRP. Their mission is to provide affordable health insurance coverage for North Carolina residents that are unable to obtain insurance through work or obtain reasonable insurance coverage due to pre-existing high-risk health conditions. NCHIRP, now doing business as Inclusive Health, started marketing in October 2008 with plan coverage starting January 2009.

Who will administer Inclusive Health Plans?

CoreSource has been selected as the administrator for Inclusive Health. This includes adjudication of claims, eligibility and benefits. All Inclusive Health claims will be submitted to CNC for processing.

How will patients know that I am a participating provider?

As a participating provider of CNC, your name will be included in the Inclusive Health Provider Directory. You may view this directory at www.inclusivehealth.org.  

What is the reimbursement on this plan?

Providers will be reimbursed based on the Medicare Fee for Service allowable amounts. Standard chiropractic services that are medically necessary will be covered. This includes, but is not limited to, x-rays, spinal manipulations, physical therapy and modalities. All services must be properly documented in the patient’s health record to show medical necessity.  

Is Maintenance or Supportive Care Covered?

No, maintenance/supportive care is not covered.

Is Acupuncture Covered?

No, acupuncture is not covered at this time.

What is the benefit plan coverage?

Inclusive Health members will have three plan benefit options to choose. All plans cover chiropractic services up to 30 visits per plan year. Chiropractic visits are subject to the patient’s deductible and will have a coinsurance after the deductible has been met. Please see below for Inclusive Health Benefit Plan details.

Where to file claims?

Please note that all chiropractic claims for Inclusive Health members must be filed through CNC, NOT TO THE ADDRESS ON THE MEMBER ID CARD.

Please also remember the CNC instructions regarding where to file claims supersede any instructions you may receive when verifying benefits. 

At this time, these claims CANNOT be filed electronically through ChiroTrack and must be sent to CNC via paper claims, using the CMS 1500 forms. 

The CNC address must be at the top of the CMS 1500, as in the example shown below.