Claims Pended for Incorrect Location

When a claim is received with an incorrect Billing, Rendering, or Attending Provider Location, the claim is pended in NCTracks. This occurs when the provider location submitted on the claim does not match the location(s) in the NCTracks provider record.

As of May 24, when a claim is pended for incorrect location, a secure message will be sent to the provider's NCTracks Message Center Inbox in the provider portal, with a link to a screen that enables the provider to select the correct Provider Location from a drop down list. The claim is then released to continue processing. This approach allows a provider to correct the claim, rather than having it deny for incorrect Provider Location.

There will be one message for every incorrect location (Billing, Rendering, or Attending) on a pended claim. If a single claim has more than one incorrect location, there will be multiple Inbox messages for the same claim.

Correcting the Location on the Pended Claim
A User Guide, "How to Update a Claim in the Pend Status resulting from an Incorrect Billing Location," has been posted to the Provider User Guides and Training page of the NCTracks Provider Portal under the heading of Claim Submission. This user guide provides step-by-step instructions for correcting the pended claims relating to an incorrect Billing, Rendering or Attending Provider Location. Alternatively, providers who use a clearinghouse or billing agent can work with their vendor to correct and resubmit the claims. 
The addresses on the pended claim must be corrected to continue processing the claim. The correct address is required in order for the claim to be validated and priced appropriately for the provider location submitted. If the pended claim has already been resubmitted with the correct location and adjudicated successfully, no further action is required. 
Correcting the Source of the Incorrect Location
In addition, the source of the location error should be corrected, so that claims submitted in the future do not pend. In some cases, the provider’s practice management software may be using the wrong address when the claim is created. In some cases, the clearinghouse or billing agent may be plugging the location into the claim when it is submitted. In either case, the location information should be changed to match what is in NCTracks. To verify what location information is on the provider record in NCTracks, the Office Administrator can review it using the Manage Change Request screens in the secure Provider Portal.
Bear in mind that there are several potential situations which can cause a claim to pend for incorrect location, such as:
- The location submitted on the claim is a Post Office Box
- The location submitted on the claim is the payment address (001)
- The location submitted on the claim is the correspondence address (002)
- There are duplicate service location addresses on file for the provider
- The effective date(s) of the location don’t match the date of service.
Providers may need to compare the pended claim(s) to the NCTracks provider record to ascertain the source of the error. 
Correcting the Location in NCTracks (If Needed)
If it is the location in NCTracks that is incorrect, the Office Administrator for the provider will need to submit a Manage Change Request to update the location information on the provider record. If the incorrect location in NCTracks is associated with the rendering or attending provider, they may have a different Office Administrator than the billing provider.
For more information on submitting a Manage Change Request to update a provider record, please see the User Guides under Provider Record Maintenance on the Provider User Guides and Training page of the NCTracks Provider Portal, as well as the Office Administrator training available in SkillPort.
 
Note: Claims pended for incorrect location prior to May 22 were denied in the May 28 checkwrite. Claims pended on May 22 and 23 will be denied in the June 3 checkwrite. These steps were taken for two reasons: 1) providers may have already resubmitted the claims with the correct location, and 2) providers who submitted claims through a clearinghouse or billing agent may not wish to correct them using the Provider Portal.  An email was sent to affected providers.
 
A list of Frequently Asked Questions (FAQs) regarding claims pended for incorrect location has been posted to the Provider Portal. If providers have other questions regarding the claims pended with incorrect location(s), please first consult the User Guide on the Provider Portal, and then if questions remain, please contact the Call Center at NCTracks Call Center at 1-800-688-6696 or NCTracksProvider@nctracks.com.