Author: GDIT, (800) 688-6696
Effective July 28, 2019, the presumptive eligibility provider enrollment process will be transitioned from NC Medicaid to NCTracks. NCTracks will assume the enrollment process for providers of presumptive eligibility for pregnant women and hospital providers of presumptive eligibility for Medicaid programs.
The requirements are not changing; however, the processes are slightly different for hospital-only providers and other medical/Medicaid providers. Separate presumptive eligibility provider agreements will be available on the NCTracks Provider Enrollment page under Quick Links (on the right side of the page) as of Monday, July 29, 2019, following implementation of the transition.
Requesting Presumptive Eligibility
Eligible providers must complete the appropriate presumptive eligibility provider application available on the NCTracks Provider Enrollment page under Quick Links, and send it to PresumptiveEligibility@gdit.com. NCTracks will send a welcome letter acknowledging receipt of the request. If any information is missing or inaccurate, NCTracks will send a return email to the provider indicating what information on the agreement is incorrect, and the provider will be asked to submit a corrected agreement.
Once all information is received, reviewed and deemed correct, NCTracks will upload the signed agreement along with any supplemental documents submitted into the provider’s record. The DHB beneficiary services department will contact the provider to schedule the required training. Beneficiary services will conduct the training and notify NCTracks when the training has been successfully completed. NCTracks will then send an approval letter to the provider that includes the provider’s name, NPI and effective date of enrollment. The effective date of enrollment in the presumptive eligibility program is the initial date the provider successfully completed the required training.