Update Expiring Credentials to Avoid Claims Suspension
Providers must submit a manage change request to update an expirable

NCTracks continues sending notifications to update the identified provider’s expiring credentials in order to avoid suspension and potential termination from NC Medicaid.

NCTracks continues sending reminder notifications to providers through the NCTracks Provider Message Center Inbox detailing the requirement to update the identified provider’s expiring credentials in order to avoid suspension and potential termination from the NC Medicaid program. For providers in suspension status, claims pend and will not pay. This is an ongoing process which began with system changes that were implemented on May 9, 2021. 

If an expiring credential (licenses, certifications and accreditations) is not updated, a reminder notice is sent at 60 days, 30 days, 14 days and seven days prior to the expiration date. Providers must submit a Manage Change Request (MCR) to update an expirable as early as possible and to allow for the approximate 10-day MCR processing timeframe. For help, refer to the NCTracks User Guide, How to Add or Update Licensing and Accreditation on the Provider Profile

Important to note: Because of the processing timeframe for MCRs, providers must submit the MCR to update their credential in time for processing to complete, prior to expiration. 

  • If a provider is suspended, claims will pend until the MCR completes processing and the provider status is updated to active. 
  • Additionally, if a provider has a pending MCR (that does not include updated credential information) at the time the reminder notification is received, the provider has the option to and is encouraged to withdraw the pending MCR, then re-submit the MCR with the license/accreditation/certification renewal information included. 
  • Again, timely submission is crucial to ensure the update is processed prior to suspension and termination. If the record is already in suspended status upon submission of an MCR, the MCR must completely process before the suspension can be lifted. 

To identify what credential is required for each taxonomy code, providers should refer to the Provider Permission Matrix (PPM), which lists specific qualifications for each provider type. The PPM and instructions for how to use it are posted under Quick Links on the Provider Enrollment page of the NCTracks provider portal.

For more information, please see NCTracks Changes to Provider Verification Process.


NCTracks Call Center; 800-688-6696 or NCTracksprovider@nctracks.com

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