To prevent delays and problems with processing reverification applications, providers should thoroughly review their provider record in NCTracks prior to submission, including taking the following actions to ensure its accuracy:
- Confirm that all active taxonomies are used by the provider. Each service location must have at least one active taxonomy, but some require additional credentials, screenings (i.e. site visit and fingerprinting), or a federal fee as published on the Provider Permission Matrix (PPM). If a taxonomy is no longer in use, end-date it to avoid possible expense and screening.
- Review each active owner and managing employee (ME), being sure to end-date any who are no longer associated with the individual provider or organization, as background checks are required for everyone who is active on the record.
- If incorrect information is displayed in a field that cannot be edited (i.e., active owner/managing employee name, date of birth, social security number), follow the applicable instructions on the NCTracks Helpful Hints page to end-date the line containing the incorrect information and add a new line with that individual’s correct information.
- This can be done through the reverification application.
- If additional assistance is needed, contact the NCTracks Call Center at 800-688-6696 for guidance.
- Confirm that the provider’s license, accreditation, and certifications are not expiring within 30 days of the date the reverification application is submitted, as this will cause the system not to allow submittal.
- Providers have 70 calendar days to submit their reverification application.
- This gives time before or after the 30-day window for submission of the application if review and response is timely.
Submitting applications with inaccurate or invalid data can lead to the application being withdrawn. If the application is withdrawn, a new application must be submitted with the correct information and will require an additional NC Medicaid application fee to be paid.
For help with the reverification process, providers can refer to the Provider Re-credentialing/Re-verification webpage in the NCTracks public facing portal. Providers are also encouraged to review Provider Announcements, User Guides and Frequently Asked Questions.
As a convenience, NC Medicaid offers a list of “Active Provider Re-Verification Due – July 2023 – Dec 2023” dates (updated biannually). The reverification due date displayed is also the suspension date if no action is taken to submit the reverification application and fee(s) under the applicable NPI. If the health plan is suspended, claims payment will stop until the reverification application is submitted.
Providers should review the reverification due date list and frequently check their NCTracks Provider Message Inbox for notifications or the reverification section of the Status and Management page in the NCTracks Secure Portal for the option to reverify.
Contact
NCTracks Call Center: 800-688-6696