Enhanced Source Verification for Enrollment and Re-verification

Effective Oct. 24, 2021, new primary source verification measures will be added to the NCTracks re-verification process in compliance with 42 CFR 455.450.

Primary verification methods will apply to enrollment requirements including licenses, accreditations, certifications and other enrollment criteria necessary for participation in NC Medicaid and Health Choice. These additional measures are designed to further safeguard the validity of NC Medicaid and Health Choice provider networks.

Providers must now review and update their provider record (including required accreditation, certification and license data), during the re-verification process, similar to the review process when completing a full Manage Change Request (MCR)*. No action is required until re-verification applications are due.

*Enrollment requirements by provider type may be found in the Provider Permission Matrix which is available under Quick Links on the Provider Enrollment page.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M21271-R-2435