License and Accreditation FAQs
This list reflects answers to frequently asked questions regarding provider License and Accreditation.
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1. How do I update my accreditation(s) using a Manage Change Request?
A new User Guide has been posted that provides step-by-step instructions for adding or updating accreditations on a provider record. It can be found on the Provider User Guides and Training page of the NCTracks Provider Portal under the heading "Provider Record Maintenance."
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2. Why am I not able to update my Drug Enforcement Agency (DEA) or Clinical Laboratory Improvement Amendments (CLIA) certification in my provider profile on NCTracks?
Providers do not need to update this information themselves. NCTracks receives a monthly data file from the DEA that is used to automatically update the expiration dates for the DEA certifications in provider records. If you have renewed your certification with DEA and your DEA number is correct in NCTracks, you can retain the certification letter and associated documents for your records.
NOTE: Clinical Laboratory Improvement Amendments (CLIA) is another certification that is updated automatically, but it occurs biweekly.
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3. Will I be prompted to update my credential(s) by NCTracks?
NCTracks sends notifications for expiring credentials (licenses, certifications and accreditations) to all enrolled providers required to be licensed, certified and/or accredited. These notices are sent to the Provider Message Center Inbox in advance of the expiration date of the credential.
On May 9, 2021, NC Medicaid will implement additional steps to ensure providers meet their contractual obligation and responsibility to keep credentials current on their NCTracks enrollment record. These steps include making system modifications to begin a process of 45- and 60-day notifications of suspension if a provider fails to update their credential prior to the expiration date on file with NCTracks. Providers were first informed of this forthcoming system modification in March of 2018.
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4. What is the timeline for these notifications?
The letter will be sent to the Provider Message Center Inbox with the subject Provider Re-certification Letter. If the credential is not updated, a reminder notification will be sent at 30 calendar days and again at 14 calendar days prior to the expiration of the credential. The final reminder is sent seven calendar days prior to expiration date.
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5. What happens if a credential is not updated by the expiration date?
The taxonomy codes that require the expired credential will be suspended if the credential has not been updated by the expiration date. A suspension letter will be generated and sent to the Message Center Inbox with the subject Recertify Suspension Letter. The suspension will remain in place for another 60 calendar days unless the credential is renewed and submitted, in which case the suspension will be lifted.
Note: Suspension means your claims will pend and will not pay until the suspension is lifted.
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6. Will my record be terminated if I fail to renew a credential?
The provider's taxonomy code(s) that requires the expiring credential will be terminated on the 61st calendar day following suspension. If the terminated taxonomy represents the only taxonomy for that location or provider record, then the service location or enrollment record will also terminate. If you are terminated, you must reapply to participate in North Carolina Medicaid and NC Health Choice programs and will not receive payment through NCTracks or our other vendors.
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7. What if my credential(s) has already expired?
For providers with credentials on file that have already expired, the timeline for notification, suspension and termination is as follows:
- Due to the number of providers impacted, the providers with expired credentials will be categorized into groups. The first group will receive notifications beginning May 10, 2021.
- First notification letters will be sent to the Message Center Inbox on staggered dates with the subject: Notification for Re-certification Letter – Expired
- If after 45 calendar days from the original notice day a provider has not updated the expired credential(s), the taxonomy code associated with the credential will suspend. A suspension letter will be sent to the Message Center Inbox with the subject: Suspension for Re-certification Letter – Expired
- An additional 30 calendar days will be given after suspension to update the credential. Thirty calendar days after the suspension date, the taxonomy will terminate if the credential has not been updated. If the terminated taxonomy represents the only taxonomy for that location or provider record, the service location or enrollment record will also terminate.
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8. How do I update my credentials using a Manage Change Request?
Refer to the User Guide “How to Add or Update Licensing and Accreditation on the Provider Profile in NCTracks” under the heading Provider Record Maintenance on the Provider User Guides and Training page of the NCTracks provider portal. NOTE: It takes approximately 10 business days to process the MCR. Providers must be sure to submit the MCR to update their credential in time for processing to complete prior to expiration.
If there is a pending MCR when the notification is received that did not include updated credential information, the provider has the option, and is encouraged to withdraw the pending MCR and resubmit with the license/accreditation/certification renewal information to ensure the update is processed prior to suspension/termination date. If the record is suspended, submission of an MCR will not lift the suspension. The MCR must completely process before the suspension would be lifted the following day.
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9. How can I find out what license(s) are required for my taxonomy code(s)?
Specific qualifications for each provider type are listed in the Provider Permission Matrix (PPM). The PPM and instructions for how to use it are posted under Quick Links on the Provider Enrollment page of the NCTracks provider portal.
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10. When keying my license number into NCTracks, should I use the dash (if there is one)?
The license number should be keyed with dashes exactly as it appears with your license authority.
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11. Why won't NCTracks accept my license number?
NCTracks receives some provider license information directly from the licensing authority, such as the Medical Board. When you key your medical license into NCTracks, it will be validated against the information received from the Medical Board or other licensing authority. However, if you have only recently obtained your license, NCTracks may not have received the information yet. (NCTracks receives updates from the Medical Board once a month for the previous month.) If you receive an error message regarding your license, try again at a later date.
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12. Why am I not able to update my Drug Enforcement Agency (DEA) or Clinical Laboratory Improvement Amendments (CLIA) certification in my provider profile on NCTracks?
Providers do not need to update this information themselves. NCTracks receives monthly data files which are used to automatically update the DEA and CLIA certifications in provider records. If you have renewed your certification with DEA and your DEA number is correct in NCTracks, you can retain the certification letter and associated documents for your records.
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13. Do I need to submit updates to my medical license, such as expiration date?
NCTracks receives a monthly data file from North Carolina Medical Board (NCMB). When this file is received, NCTracks automatically updates the expiration dates in the provider record, so you should not need to update it yourself in NCTracks as long as it is current with NCMB.
When a provider enters their medical license into NCTracks, it is validated against the information received from the Medical Board or other licensing authority. However, if the provider has only recently obtained a license, NCTracks may not have received the information yet. (NCTracks receives updates from the Medical Board once a month for the previous month.) If an error message is received regarding the license, try again at a later date.
If you receive a letter that you need to update your NCMB license, make sure it is updated with NCMB and that NCTracks has the correct license number on file.
Occasionally, there is time gap between NCTracks receiving NCMB data with updated expiration dates and providers’ licenses expiring and an update being required to prevent suspension. As of May 9, 2021, providers have the ability to enter or correct the expiration date on file for their NCMB license if NCTracks has not yet received the NCMB data to update the license. Providers are able to enter the expiration date themselves to prevent suspension or termination due to expired credentials. This information will still be validated with NCMB once the file is received, but will prevent suspension for expired credentials if the NCMB file is not received in the appropriate timeline for license expiration. Providers are encouraged to ensure their record expiration date is updated to prevent suspension. For more information on this update, please see the Medicaid Bulletin Changes to Provider Verification Process in NCTracks Begin May 9, 2021.
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14. What if I have additional questions?
Providers with questions may contact the NCTracks Call Center at 800-688-6696 or NCTracksprovider@nctracks.com.