NC Medicaid implemented system changes on May 9, 2021, requiring providers to keep credentials current on their NCTracks provider enrollment record. Notifications are sent 60, 30 and 14 calendar days prior to the expiration date of a credential, advising providers of the requirement to update the credential and the resulting suspension of claims for providers who fail to do so.
Once a 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 NCTracks 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 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, then the service location or provider record will also terminate.
- If the provider record terminates, reenrollment 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.