During the transition period after NC Medicaid Managed Care launch, Children’s Developmental Services Agency (CDSA) providers experienced billing and payment issues. The issues have been identified and resolved.
Effective immediately, CDSA providers may submit their claims to NCTracks for all individualized family service plan (IFSP) services for dates of service starting on July 1, 2021.
Effective July 1, 2021, CDSAs and CDSA-contracted providers must submit all IFSP service claims to NCTracks with the TL modifier.
Effective July 1, 2021, NC Medicaid is temporarily waiving existing prior approval (PA) requirements for CDSAs and independent practitioners who provide ISFP services on behalf of a CDSA.
- Providers will be notified when PA requirements are reinstated.
- Providers should be prepared to submit PA requests when PA requirement is reinstated.
- All claims are subject to audit.
Please note, for beneficiaries enrolled in NC Medicaid Managed Care, other services provided by independent practitioner providers that are not IFSP services must be billed to the prepaid health plan (PHP) with whom the beneficiary is enrolled. The PHPs may request additional information to validate that the services are not IFSP services.
Thank you for your patience and cooperation. If a provider continues to have unresolved billing and payment issues, they should contact the NCTracks Call Center at 800-688-6696.