Frequently Asked Questions:

Who is eligible for migrant health fee-for-service funds?
What services are covered?
How does one get reimbursed for services?
How are claims submitted?
Who does one call for assistance or more information?

Eligibility

Eligibility is determined by agencies that have been designated as Migrant Health Entry Points. MHEPs are entities that have been designated by NCFHP to certify migrants, based on density of farmworkers, number of farmworker patients served by the agency, and the agency's ability to offer linguistically-appropriate services, night hours, and outreach services.

Migrant Health Entry Points (MHEPs) are responsible for enrolling migrant farmworkers in the Migrant Health Fee-for-Service program using the Migrant Health Fee-for-Service Eligibility Form (DHHS 3753). These forms may be completed only at Migrant Health Entry Points.

The Program encourages physicians, dentists, optometrists, laboratories, hospitals, and other service providers to collect a $5 co-payment from patients for each date of service.

Eligible medical and dental services are reimbursed based on the current Medicaid rate to a maximum of $150 per claim and date of service visit.

If your site is interested in becoming a MHEP, please contact the Migrant Health Fee-for-Service Program Manager at (919) 733-2040 ext 233 for further details.

For Provider Reimbursement: Providers ELIGIBLE for reimbursement of services rendered to migrant farmworkers include private physicians and mid-level providers, dentists, mental health counselors, optometrists, hospitals, laboratories, and radiology facilities.

The Migrant Health Fee-for-Service Program is considered the payor of last resort. Migrant farmworkers eligible for other third-party coverage must have those resources billed prior to billing the Migrant Health Fee-for-Service Program. Third-party reimbursement includes private insurance, Worker's Compensation, Medicaid/ NC Health Check, NC Health Choice, and Medicare. Other Purchase of Medical Care Services (POMCS) Programs (including kidney, HIV, and sickle cell chronic care) and Children's Special Health Services are available, and should be considered for coverage of applicable chronic conditions.

We encourage MHEPs and providers to utilize other public health programs and community-donated services and medical supplies as much as possible in order to conserve Program funds.

NOT ELIGIBLE for reimbursement are health departments, public mental health centers, migrant health centers, community health centers, and independent National Health Service Corps sites.

For Coverage of Migrant Farmworkers: Migrant farmworkers and their dependents are ELIGIBLE for Migrant Health Fee-for-Service while residing in North Carolina. A dependent is an individual who resides with and is financially supported by the farmworker, and typically may be one or more of the following: a spouse, partner, parent, child, or minor sibling (age 18 and under).

Eligibility for Migrant Health Fee-for-Service is based on employment (financial determination or residence documentation are not required). A migrant farmworker is someone who within the last 24 months 1) has worked in agriculture (at least 51% of total annual income) and 2) has moved to temporary housing for agriculture. The migrant farmworker may be employed through a crew leader, by contract (H2A or other), or by the farmer.

Migrant farmworkers who are no longer performing agricultural labor due to age or disability also qualify.

Agriculture includes cultivating or harvesting crops on or in the land, and/or are preparing crops for market or storage. Crops include fruit and vegetable field crops, Christmas trees and wreaths, orchards, nurseries and greenhouses, harvesting of wild plants, and reforestation.

Individuals NOT ELIGIBLE include:

• crew leaders who are not doing agricultural work, or who are salaried
• persons employed in residential or commercial landscaping, seafood processing, meat or poultry processing plants, the care of farm animals, lumbering, or saw mill work
• seasonal farmworkers who do not migrate

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Covered Services

... for Reimbursement

• Medical care provided in-office or hospital outpatient facility
• Dental services including basic preventive, simple restorative, and simple surgical
• Mental health services
• Laboratory tests and diagnostic x-rays

Services NOT COVERED

• Emergency room visits
• Ground or air ambulance transportation
• Inpatient, custodial, or hospice care
• Routine physical, vision, or hearing exams(diagnostic exams are covered)
• Any elective procedure, including circumcision, sterilization, or abortion
• Eyeglasses or hearing aids
• Speech therapy
• Chiropractic services
• Pharmacy

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Enrollment

Migrant Health Entry Points (MHEPs) enroll eligible migrant farmworkers in the program and should provide copies of the Migrant Health Eligibility Form to both the provider at time of referral and to the patient. If a copy was not received from the MHEP with the referral and the patient does not have a copy of their Migrant Health Eligibility Form with them at the time of seeking care, providers should call the Purchase of Medical Care Services at 919-855-3701 to verify enrollment.

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Submitting Claims

To submit a claim for reimbursement, the provider should submit the appropriate provider claim form to Purchase of Medical Care Services (POMCS) within one year of the date of service. Providers are encouraged to bill promptly after services are provided because claims for covered services will be paid on a first-billed, first-paid basis until funds are depleted. Claims should receive payment within approximately 45 days of the date the completed claim is received by Purchase of Medical Care Services.

Claim forms can be requested from:
Purchase of Medical Care Services
Office of the Controller
1904 Mail Service Center
Raleigh, NC 27699-1904

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Contact Information

SEND MIGRANT HEALTH APPLICATIONS AND PROVIDER CLAIM FORMS TO:
Purchase of Medical Care Services
Office of the Controller
1904 Mail Service Center
Raleigh, NC 27699-1904
NOTE: Do not put "Migrant Health" when putting address on correspondence, as it will delay processing.

FOR MORE INFORMATION REGARDING PROGRAM RULES, please contact:
Ann Watson, Program Manager
North Carolina Farmworker Health Program
2009 Mail Service Center
Raleigh, NC 27699-2009
Email: ann.watson@dhhs.nc.gov
Phone: (919) 733-2040
FAX: (919) 733-2981

FOR CLAIM INQUIRIES:
Providers with questions about claims or who have not received payment for claims within approximately 45 days should call Purchase of Medical Care Services Claims Unit at (919) 855-3702.

FOR ELIGIBILITY INQUIRIES:
If you have a question about eligibility applications already on file, call the Purchase of Medical Care Services Eligibility Unit at (919) 855-3701.

OTHER PURCHASE OF MEDICAL CARE SERVICES NUMBERS:
Purchase of Medical Care Services Claims Unit
Main number (919) 855-3700
FAX (919) 733-0352