North Carolina Announces Changes to the Medicaid Re-Credentialing Process

13141598_S_doctor_forms_stethoscope.jpg

The North Carolina Department of Health and Human Services (N.C. DHHS) has announced significant changes to the re-credentialing process for Medicaid health care providers.

Changes to the NCTracks system, the new multi-payer Medicaid Management Information System, are effective April 29, 2018 and include the following:

  • The timeline for re-credentialing notification, suspension and termination will be modified. The first notification will now be sent 70 days before the provider’s re-credentialing due date.
  • Reminders will be sent 30 days, 15 days and 5 days before the provider’s due date ifthe re-credentialing application is not submitted.
  • If the re-credentialing application is not submitted by the due date, the provider will be suspended from North Carolina Medicaid and North Carolina Health Choice programs.
  • At the end of the month following 30 days of suspension, the provider will be terminated from the North Carolina Medicaid and NC Health Choice programs.

Re-credentialing is mandatory, so providers receiving a notice must respond promptly to begin the process. There is a $100 application fee for re-credentialing.

Other important changes are in regard to Manage Change Request (MCR) Applications. If a change is required using a MCR, the MCR process must be completed before the re-credentialing due date instead of extending this due date. Also, the application appearing on the NCTracks Provider Portal will be modified to show more ownership information and to allow the provider to edit, end-date, or add to it.

The N.C. DHHS urges all providers to review their electronic NCTracks records thoroughly. Make sure that the information is current and accurate, and correct if necessary.

Changes to Reverification

Providers must also update expiring certifications, licenses and accreditations in the system. Those who fail to respond within specific time limits will be suspended and terminated.

You can read all the details about these NCTracks changes and other important provider announcements here

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.