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Instructions for Completing the PCP Assignment Changes Spreadsheet for Members Enrolled with WellCare of North Carolina

View more details about AMH/PCP Assignment.

PCP Assignment Overview


NOTE: If you do not know your assigned Provider Relations Representative's email, please email your information to: NCProviderRelations@WellCare.com.

Request to assign members into your practice

If your office notices your AMH/PCP is not listed on a member’s ID card or if the member requests assistance changing their AMH/PCP to your practice, you have the following options:

  1. Inform the member that they can call Member Services at 1-866-799-5318 to request an AMH/PCP change.
  2. Complete a copy of the AMH/PCP Change Request Form for Prepaid Health Plans (PHPs) (PDF), obtain the member's signature, and fax the completed form to 1-855-247-7480.
  3. For multiple members, complete the AMH/PCP Assignment Change Request spreadsheet and send to your Provider Relations Representative via encrypted email. 

Spreadsheet Completion Requirements

  • Complete all required columns. Incomplete spreadsheets will NOT be processed.
  • Complete the attestation at the bottom of the spreadsheet.
  • The reason for the reassignment can include details such as the date of the last visit.

NOTE: AMH/PCP assignments apply to the practice or group location, not an individual provider. An AMH/PCP change is NOT necessary if the member is seeing a different provider at the same AMH/PCP practice location.


Request to assign members out of your practice

If you believe a member should not be assigned to your AMH/PCP, such as in cases where the member has been discharged has transferred their care to another AMH/PCP, you have the following options:

For Discharged Patients:

  1. Use the secure provider portal: 
    • Select “Request Member Transfer” under “Select Action” after entering the member ID on the “Check Member Eligibility” page. 
  2. Submit an AMH/ PCP Transfer Request Form (PDF) via fax.
  3. For multiple members, complete the AMH/PCP Assignment Changes Spreadsheet and send to your Provider Relations Representative via encrypted email.

Spreadsheet Completion Requirements:

  • Do not complete the columns labeled “NEW AMH/PCP” in the header row.
  • Fill out all other required columns. Incomplete spreadsheets will NOT be processed.
  • Complete the attestation at the bottom of the spreadsheet.
  • The reason for reassignment can be “discharged from practice.”
  • Attach supporting documentation, such as a discharge letter.

Note: For more information on discharged patients, refer to “Can I remove members that are assigned to my practice?” on the AMH/PCP Assignment Overview page.

For patients that have moved or changed AMH/PCPs:

  1. Complete the AMH/PCP Assignment Changes Spreadsheet and send to your Provider Relations Representative via encrypted email.

Spreadsheet Completion Requirements:

  • Fill out all required columns. Incomplete spreadsheets will NOT be processed.
  • If the new AMH/PCP information is unavailable, note it in the spreadsheet as “not available.”
  • Complete the attestation at the bottom of the spreadsheet.
  • Provide a reason for the reassignment, such as:
    •  “Member moved out of service area” (include the new address).
    •  “Member transferred to another AMH/PCP.”
  • Attach supporting documentation, such as:
    • A medical record transfer request.
    • Documentation of a discussion with the member in the patient’s medical record.

Important Notes

  • All AMH/PCP assignment changes require NC Medicaid confirmation.
    • Once confirmation is received, the member will be notified with a new ID card, and the provider will receive notification via fax or email.
  • Effective date of PCP Assignment:
    • Requests received on or before the 16th of the month: The change will be effective on the 1st of the following month
    • Requests received after the 16th of the month: The change will be effective on the 1st of the second following month.
  • Medicaid Beneficiaries can change their AMH/PCP up to two times per year:
    • Members may change within 30 days of AMH/PCP assignment for any reason.
    • Members can request one additional change per year without cause.