Expanded NCTracks Contacts for Optical Providers

Effective Aug. 1, 2023, NCTracks expanded the optical services team to include the Call Center Tier 1 staff, optical prior approval analysts and opticians.  

Providers should call the NCTracks Call Center with questions regarding all eyeglasses prior approval for NC Medicaid Direct (fee-for-service) and NC Medicaid Managed Care health plans.  

NC Medicaid Direct

Providers should also call the NCTracks Call Center for Medicaid Direct routine eye exams and medically necessary contact lenses. This includes policy questions, prior approval status and guidance, and assistance with Medicaid Direct optical services. If the provider has contacted NCTracks and still needs assistance, the provider may contact the NC Medicaid Provider Ombudsman.

For every call, providers should always record the NCTracks ticket number, date and the NCTracks staff person they spoke with.   

NC Medicaid Direct Contacts 

NC Medicaid Managed Care

Providers with questions about routine eye exams, medically necessary contact lenses and eyeglasses dispensing fees for beneficiaries enrolled in a managed care health plan should contact the health plan. If the provider has already contacted the beneficiary’s managed care health plan and still needs assistance, the provider may contact the NC Medicaid Provider Ombudsman.  

Managed Care Health Plan Contacts 

Reminders

• All eyeglasses frames, lenses and fabrication are carved out of managed care. All inquiries regarding eyeglasses prior approval and clinical coverage polices should be directed to the NCTracks Call Center.    
• All eyeglasses are fabricated by Nash Optical Plant. All inquiries about eyeglasses order receipt or fabrication status should be directed to Nash Optical Plant.  
• Providers should not contact health plans about any eyeglasses prior approval, clinical coverage policy, or fabrication.