Designating Individual Provider Participation in Carolina ACCESS

In NCTracks, individual providers can affiliate with one or more groups/organizations that bill for services on their behalf. Beginning March 2, there will be a new question on the provider enrollment application. When an individual provider affiliates with an organization in NCTracks, if the organization participates in Community Care of North Carolina / Carolina ACCESS (CCNC/CA), they will be presented the question, “The group that you have selected is a CCNC/CA provider. Do you wish to participate in CCNC/CA under this group at this location?� This question will only be presented when the individual provider is eligible to be a CCNC/CA provider. (For example, the question will not be presented to a dentist.) This information will be used to create the Carolina ACCESS Provider Directory. Providers who select "Yes" will be listed in the directory as a participating provider under the group practice.

For existing rendering and attending providers who are already affiliated with a group/organization participating in CCNC/CA, the assumption will be that the rendering/attending provider will participate in CCNC/CA under the group. If the rendering or attending provider does not wish to participate in CCNC/CA, the Office Administrator for the rendering/attending provider can submit a Manage Change Request in NCTracks to change their designation by answering “No� to the above question.

In addition, if an individual provider who participates in CCNC/CA changes their response to the question “Are you rendering/attending only?� from No to Yes when submitting a Manage Change Request, a warning message will be displayed, “This change will result in the termination of your CCNC/CA participation and your recipients will be reassigned. If you have questions, please contact your local Managed Care Consultant.�

For more information about CCNC/CA, contact your regional Managed Care Consultant, as designated in http://www.ncdhhs.gov/dma/ca/mcc_051214.pdf. For step-by-step instructions regarding submission of a Manage Change Request to update affiliations, see the User Guide “How to Affiliate an Individual Provider Record to a Group-Organization in NCTracks” under the heading Provider Record Maintenance on the Provider User Guides and Training page of the NCTracks Provider Portal.