NCTracks Coming Attractions - Changes Arriving January 28, 2018

Upcoming Changes & Updates to the NCTracks System

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Facility Providers Can View Sterilization Consent Form Status and Denial Reasons

Effective January 28, 2018, facility providers will have access to the sterilization consent form status, including denial reasons, on the NCTracks provider portal.

Once the beneficiary has had the surgery and before submitting the completed sterilization consent form to the N.C. Department of Health and Human Services (DHHS) fiscal contractor, the surgeon's NPI must be added to the top left of the consent form. The beneficiary's identification number must be added to the top right of the Sterilization Consent Form. Forms without this information cannot be processed. The facility NPI in which the sterilization procedure was performed may be added to the top center of the consent form. To ensure that the facility in which the procedure was performed can make inquiries concerning the sterilization consent form status, the facility NPI field must be populated upon initial submission of the consent form to DHHS fiscal contractor.

Providers can access the Sterilization Consent Form on the U.S. Department of Health & Human Services website. A job aid is being created for providers regarding data used to complete the form and access consent form status. Please check the Provider Training page on the NCTracks Provider Portal for an announcement when the job aid is available.

For more information and instruction for completing the Sterilization Consent Form, providers should refer to DMA Clinical Policy 1E-3, Section 5.3, Sterilization Procedures, page six of the Obstetrics and Gynecology Clinical Coverage Policies document on the NC DMA website. Providers with questions can contact the CSRA Call Center at 1-800-688-6696 or NCTracksprovider@nctracks.com.

 

Updated Requirements for MCR, Re-verification, Re-enrollment, and Enrollment Applications

Effective January 28, 2018, NC Medicaid will update several requirements which will impact some applications:

1. The $100 NC Application Fee will be required for:

  • Initial Enrollment Application for NC Medicaid and/or Health Choice (Note: This includes Out of State (OOS) full enrollment applications)
  • Re-verification Application (every five years) when the provider is active in Medicaid and/or Health Choice
  • Resubmitted application due to a withdrawn, abandoned, or denied application
  • OPR Lite Enrollment Application
  • Managed Change Request (MCR) to change an (OOS) Lite enrollment to a full enrollment

Note: The fee is not required for Re-enrollment applications or Out of State (OOS) Lite providers.

2. Changes to Affordable Care Act (ACA) Fee Collection and Site Visits Processes for Moderate and High Risk Providers

Effective January 28, 2018, providers designated as moderate or high risk* will notice changes to the processes for collection of ACA fees and site visits. The ACA fee (pursuant to Section 6401(a) of the ACA) is in addition to the NC Application fee.  These changes will impact:

  • Re-verification Applications
  • MCR to add a new site location
  • Re-enrollment Applications

ACA fee collection, which is currently manual, will be automated. Additionally, the site visit will no longer occur post enrollment. The ACA fee collection and site visit will occur during processing of the Re-enrollment, Manage Change Request, and/or Re-verification Application.

Note: Currently, the site visit for initial enrollment applications occurs during processing.

*Providers are identified as moderate and high risk as outlined in 42 CFR 424.518(c) and NC General Statute 108C-3g. Refer to the Provider Permission Matrix, on the Provider Enrollment page of NCTracks for more details.

3. Additional Information

Changes will be made to the Enrollment, Re-enrollment, Manage Change Request, and/or Re-verification Applications to include a new ACA page. Therefore, all applications saved as a draft will be deleted on January 28th due to changes being made to the Provider Portal Application.

NCTracks Provider Training documents will be available in Skillport in late January. Please reference the Provider Training page on the NCTracks Provider Portal for an announcement when training is available.