Provider Training for Enhancements to Recipient Eligibility Inquiry

Effective March 24, several enhancements related to Recipient Eligibility Inquiry will be implemented in NCTracks. These system changes are being implemented as part of the CAQH CORE (Phase I and Phase II) standards. (For more information about CAQH CORE, see link below.)

The enhancements on the NCTracks Provider Portal include:

• Normalization of the recipient last name in search criteria -Providers may enter the beneficiary's last name in the search criteria with spaces, special characters, hyphens, etc.
• Service type selection capability in search criteria -Providers may enter up to 5 specific service types in search criteria in an inquiry. If no service types are specified, the system returns up to 54 covered service types.
• Copay information by service type in the search response- Co-pay information is returned with each service type in the response.

There will be three 30 minute training sessions about the Recipient Eligibility Inquiry enhancements offered for providers. Each session will cover the same information, so providers can attend whichever session is most convenient. All of the sessions will be conducted via webmeeting. The sessions will be held on:

Wednesday, March 19 at 10:00 AM
Thursday, March 20 at 10:00 AM and 3:00 PM

Attendance is limited to 120 per session. Providers can register for a session in SkillPort, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder lableled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The "Provider Training for Enhancements to Recipient Eligibility Inquiry" course can be found in the sub-folder labeled ILTs: Remote via Webex. (Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use SkillPort.) For those who are unable to attend the training sessions, the training materials will be posted to SkillPort. Also, two existing Computer Based Training courses and two Participant User Guides are being updated to reflect the new information, and they will also be available on SkillPort.

In addition, on March 24, a new communication channel will be available to trading partners for submission and receipt of 270/271 and 276/277 HIPAA X12 transactions. The NCTracks Trading Partner Connectivity Guide is being updated with information regarding the new communication channel for 270/271 and 276/277 transactions. The updated version of the Guide will be loaded on the Trading Partner Information page of the NCTracks Provider Portal.