The federal COVID-19 Public Health Emergency (PHE) ended on May 11, 2023.
Provider Reverification and Billing Modifications Reminder
May 16, 2023 2:30:00 PM / by Practice Support Team posted in Medicaid, Medicaid Managed Care, nctracks
Re-verification requirement for NC Medicaid
Feb 22, 2023 9:43:16 AM / by Practice Support Team posted in Medicaid, Medicaid Managed Care, nctracks, public health emergency
The Centers for Medicare and Medicaid Services (CMS) requires that all Medicaid providers are recredentialed, a process also referred to as reverification. Since March 2020, CMS has allowed for the suspension of reverification due to the Public Health Emergency (PHE) brought on by COVID-19.
NCTracks: Important Changes Coming
Feb 6, 2023 8:16:00 AM / by Practice Support Team posted in Medicaid, Medicaid Managed Care, nctracks, practice management
Currently, NCTracks compares the managing employees (ME) listed on an organization's initial enrollment application against the managing employees listed in the Medicare Provider Enrollment, Chain and Ownership System (PECOS). If managing employees listed on the application does not match those listed in PECOS, the application is denied.
Medicaid Managed Care: What Providers Need to Know
Sep 22, 2021 2:00:00 PM / by Practice Support Team posted in Medicaid Managed Care, Primary Care, nctracks
- From the NC Medicaid 2021 Provider Playbook, you will find Updated FAQs on Medicaid Managed Care Claims and Prior Authorizations. Some examples of FAQ topics include: how to file a claim with each of the PHPs, what information is needed from the provider to file the claim, portal messaging and how to submit prior authorizations to a health plan and many other topics. There are helpful links and the PHP Claims Schedule through October 2021.
Medicaid Managed Care: NCTracks AVRS Updated with PHP information
Jul 22, 2021 6:30:00 AM / by Practice Support Team posted in Medicaid Managed Care, nctracks
Prepaid Health Plan Information Added to NCTracks Automated Voice Response System
As part of recent NC Medicaid Managed Care updates, NCTracks accepts beneficiary enrollment and eligibility inquiries through the Automated Voice Response System (AVRS) which can be reached at 800-723-4330. The AVRS response includes the Prepaid Health Plan (PHP) name, contact information and the PHP assigned Primary Care Provider (PCP)/Advanced Medical Home (AMH). The response also includes a reminder that all care must be coordinated through the PHP.
Medicaid Managed Care: Panel Management Fact Sheet Released
May 26, 2021 1:15:00 PM / by Practice Support Team posted in Medicaid Managed Care, nctracks
NCDHHS recently released a fact sheet on Panel Management. We pulled some highlights from the fact sheet for you on the blog today.
Medicaid Managed Care: Glidepath Payment Reconsideration Process
Apr 28, 2021 8:13:00 AM / by Practice Support Team posted in Medicaid Managed Care, NCDHHS, nctracks, glidepath
As a reminder, once an AMH Tier 3 practice has attested to meeting Glidepath payment eligibility in NCTracks, DHHS will validate that the practice is enrolled with NC Medicaid and attested as an AMH Tier 3 practice. DHHS then confirms the attestation with the respective pre-paid health plans in order to validate that each Tier 3 practice has met contracting and testing criteria.
HOSAR Payment Denials - Medicaid Managed Care
Apr 27, 2021 4:30:00 PM / by Practice Support Team posted in telehealth, nctracks, hosar
Providers with Denials for Healthy Opportunities Screening, Assessment and Referrals Claims due to Edit 02088 May Now Resubmit Claims
Provider Data Updates in NCTracks: Medicaid Managed Care
Apr 21, 2021 9:00:00 AM / by Practice Support Team posted in Medicaid, Medicaid Managed Care, NCDHHS, nctracks
On Wednesday April 14th, 2021 NCDHHS posted Provider Data Updates highlighting the importance of ensuring provider data is correct in NCTracks. Please see important highlights below and click on the links for more complete information.
Glidepath Payments Attestation Now Live in NCTracks
Mar 10, 2021 4:45:00 PM / by Practice Support Team posted in Medicaid, advanced medical home, nctracks, glidepath
Advanced Medical Homes Tier 3 “Glidepath” Payments Update
In February, NC Medicaid announced that effective April 1, 2021, NC Medicaid will offer time-limited payments to practices that have attested as an AMH Tier 3 provider as part of the transition to Medicaid Managed Care.