As a reminder, NC Medicaid is taking additional steps to ensure providers meet their contractual obligation to keep credentials current on their NCTracks enrollment effective May 9, 2021. NCTracks will generate a notification to providers at 60, 30 and 14 calendar days prior to the expiration date of the credential; and will begin a process of suspension if a provider fails to update their credential.
- Choosing from providers with complete and up-to-date licensure, certification and accreditation information allows NC Medicaid beneficiaries to make informed choices to achieve the best health outcomes.
- System modifications alerting providers to update expiring credentials will assist providers in meeting federal and State enrollment and credentialing requirements and will assist NC Medicaid in removing unlicensed providers and expired credentials from provider records.
- With updated provider information, NC Medicaid will be able to transmit accurate provider data to health plans and other departmental partners who serve Medicaid beneficiaries.
When the credential expires:
- The taxonomy code that requires the expired credential will suspend if the credential has not been updated by the expiration date.
- A suspension letter will be generated and sent to the Message Center Inbox with the subject ‘Recertify Suspension Letter.’
- The suspension will remain in place for another 60 calendar days. If the credential is renewed, the suspension will be lifted.
Note: Suspension means your claims will pend and will not pay until the suspension is lifted.
- The taxonomy code that requires the expired credential will terminate on the 61st calendar day following suspension.
- If the terminated taxonomy represents the only taxonomy for that service location or provider record, the service location or provider record will also terminate.
- If the provider record terminates, re-enrollment is required to participate in the Medicaid and NC Health Choice programs. Payment is not allowed through NCTracks or any other vendor until a provider is actively enrolled with NC Medicaid.
For more information, please see NCTracks Changes to Provider Verification Process.
NCTracks Call Center: 800-688-6696 or NCTracksprovider@nctracks.com