New Interim Reports to Assist Providers in Verifying Their Records

Wednesday, January 13, 2021

Provider Directory Listing Report

The Provider Directory Listing Report is available to providers for the purpose of providing transparency about their Health Plan(s) contracting status, as well as the manner in which their data will appear in the public-facing provider directory once it launches. 

The report contains all active Medicaid and NC Health Choice providers that will be published on the Enrollment Broker (EB) website in the Medicaid and NC Health Choice Provider and Plan Lookup Tool. This list includes Primary Care Providers (PCPs) and specialty providers who are contracted with a Health Plan and/or Tribal Option as well as providers who are not participating in managed care to reflect the NC Medicaid Direct provider population. 

The report also identifies practices slated to be included in the auto-assignment process due to their participation with the Advanced Medical Home program, and gives providers the opportunity to correct erroneous demographic and affiliation data on their enrollment record in the secure NCTracks Provider Portal.

The report, which will be updated weekly, is available on the NC Medicaid Provider Playbook Resources webpage.

Provider Affiliation Report

The Provider Affiliation Report contains all active organizations, their service location and each affiliated individual provider. This report will only display individual to organization affiliations as found in NCTracks. 

  • If there are no such affiliations, no information will be displayed. 
  • The information listed will also be used by the EB to populate their public-facing provider directory. 
  • Organizations should use the search function to find the practice and verify the accuracy of the affiliated providers for the location listed and identify any invalid affiliations.
  • Individual providers should use the search function to validate affiliation to both the organization and the organization location. 

Providers may use the NCTracks Managed Change Request (MCR) process, available in the Secure NCTracks Provider Portal, to modify any provider record or service location information as well as individual to organization affiliations. If the Provider Affiliation information is incorrect, the affiliated provider or the Office Administrator for the affiliated provider must update the group affiliation. Providers unable to find their practice associated with the correct Health Plans, should reach out directly to the Health Plan to discuss contracting options. Contact information can be found on the Health Plan Contacts and Resources webpage.

Note: A Field Description tab is available on the report to connect the section of the MCR to the field in the report displaying the information. 

Additional information on updating an NCTracks provider record can be found here. Providers needing additional assistance with updating the information on their NCTracks provider record may contact the NCTracks Contact Center at 800-688-6696. 

Beneficiaries will begin using the tool for open enrollment starting March 15, 2021.

The report, which will be updated weekly, is available on the NC Medicaid Provider Playbook Resources webpage.

Contact

NCTracks Contact Center: 800-688-6696