Discussing Some Crucial Details Regarding NC Tracks

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A variety of business sectors can access the internet through three different portals offered by NC Tracks (Providers, Recipients and internal operations needs). Unable to reset your NCID password as the Office Administrator, you’ll need a new one. A new NCID will be required. Using a new service, providers may now use NCTracks to verify the eligibility of recipients. You can verify Medicaid eligibility on NC Tracks first, and if that information isn’t accessible you can call the NC Tracks Call Center to find out.

Significant Matters

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A user may have a valid Medicaid or Health Choice ID card yet not be identified as eligible in NCTracks, according to certain providers. Some eligibility adjustments from NC FAST may take up to a week for NCTracks to obtain. This is common with infants and recipients who have just regained eligibility following a period of ineligibility. As a result, the NC Tracks Call Center may now check recipient eligibility in the NC FAST system directly. Before delivering services, a provider will be able to check the recipient’s eligibility.

Eligibility Details

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Be sure to visit NC Tracks for eligibility information before contacting the Call Center to verify NC FAST eligibility for your recipient before calling. Once NC FAST has been verified, there is no need to call our Call Center in order to confirm eligibility. In NCTracks, eligibility information may be confirmed by using the provider portal, the Automated Voice Response System (AVRS), or a 270/271 X12 transaction, among other methods of verification. Check the provider training resources in SkillPort if you need additional information on NCTracks eligibility verification. Only users registered in Medicaid and Health Choice can use this service provided by the Call Center. They have yet to be added to NC Tracks.

Crucial Factors

Keep in mind that the purpose of this service is to allow clinicians to check eligibility before providing health care to patients. Providers must still double-check the recipient’s eligibility information in NC Tracks before submitting the claim, or the claim will be rejected.

The taxonomy code linked with the rendering provider is a typical mistake discovered in claims entered through the NC Tracks Provider Portal. The rendering provider should not utilise the group taxonomy code. If such is the case, the claim will be denied. The rendering provider and the group each have their own taxonomy codes, which should be represented on the claim. The sole exception is claims filed with the Department of Mental Health (DMH). The rendering provider can be allocated a group taxonomy code for DMH claims.

Things To Keep In Mind

To obtain eligibility information on a recipient at NC Tracks, both the provider and the beneficiary must be registered in the same benefit plan (s). If a provider solely provides Medicaid services, for example, they will not be able to know if a recipient is eligible for Public Health services. The error message on the AVRS when enquiring about recipient eligibility is “Provider number and recipient ID are not connected with the same benefit plan.” “Benefit plan information is not accessible because the recipient ID and provider number submitted are not connected with the same benefit or health plan,” says the error notice while checking recipient qualification on the payment gateway.

Final Takeaways

On July 1, 2013, NC Tracks was implemented, and it included a requirement that all revenue codes on outpatient hospital claims contain an HCPCS code. That criterion has been modified, as stated in the January 22, 2014 provider portal release. Prior to July 1, if the revenue code needed an HCPCS code, it will continue to do so. If the revenue code did not need an HCPCS code until after July 1, it is no longer necessary; nevertheless, because DHB is capturing the data for future use, it is advised to be billed on the claim whenever possible. If a revenue code is provided with an HCPCS code, the HCPCS code must be current and valid on the day of service.

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