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NCTracks

Frequently Asked Questions (FAQs)

This section provides answers to frequently asked questions about North Carolina’s replacement Medicaid Management Information System (MMIS). It is organized in broad categories to make it easier to find answers related to specific topics. Click on a heading in the drop down menu to view questions and answers on a particular subject.

Should you have a question you would like to submit, please send an e-mail to Provider Relations (OMMISS.ProviderRelations@dhhs.nc.gov). Providers of MH/DD/SAS State-funded services will continue to contact their contracted LME.

General

  1. When does the new system go live?
  2. What is a multi-payer system?
  3. What does MMIS equate to in our present world?
  4. What improvements for providers are you anticipating from this new system?
  5. What features will be available in the new NCTracks Provider Portal?
  6. What is the expected impact of the new system on my organization?
  7. What efficiencies will I gain from using the NCTracks Provider Portal?
  8. Will the current EDI agreement suffice for all electronic transactions? new
  9. Who in my organization needs to have an NCID?
  10. Is there a limit to the number of staff in my organization who can utilize the NCTracks Provider Portal?
  11. How will access to the various functions within the NCTracks Provider Portal be managed?
  12. What are some examples of how business processes might change?
  13. How will the State of North Carolina help providers get ready for the new system, NCTracks?
  14. After go-live, how and where will my staff be able to submit questions on technical or other issues we discover after using the system?
  15. What support can I expect during the initial go live period?
  16. How will my needs for support from the call center change?
  17. Will local setup and configuration be needed before we can use the NCTracks Provider Portal?
  18. What is the cut-over schedule for the go live transition from the legacy MMIS system to NCTracks?
  19. How can I make the implementation successful for my organization?
  20. Where can I find information and resources on NCTracks?
  21. How can I automatically receive updates regarding the NCTracks installation?

 

  • When does the new system go live?
    The Centers for Medicare and Medicaid Services (CMS) and the NC Department of Health and Human Services (DHHS) have approved an extension of the schedule to design, develop & implement NCTracks, the Replacement MMIS that will be operated by CSC. The amended schedule moves the NCTracks operational start date to 2013.

    The NCTracks Operational Start Date for claim adjudication is July 1, 2013.

    More information and a schedule of activities will be provided at a later date.
  • What is a multi-payer system?
    NCTracks will be used by the Division of Medical Assistance (DMA), the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS), the Division of Public Health (DPH), the Migrant Program for the Office of Rural Health and Community Care (ORHCC). Providers enrolled in DMA, DPH, and ORHCC health plans will submit claims for covered health care services to NCTracks Provider Portal. NCTracks will coordinate processing among the payers to ensure the proper assignment of the payer, benefit plan, and pricing methodology for each service on a claim. NCTracks will process health care claims for about 70,000 enrolled DHHS providers who serve over a million North Carolina citizens.

    Providers who are contracted by Local Management Entities (LMEs) to perform state funded DMH/DD/SAS services will continue to submit their claims to the LME.
  • What does MMIS equate to in our present world?
    NCTracks is the multi-payer Replacement MMIS that will be operated by CSC.
    NCTracks will adjudicate claims for the following NC DHHS programs:
    • NC Medicaid
    • NC Health Choice
    • Division of Mental Health programs
    • Division of Public Health Purchase of Medical Care Services (POMCS) Program, including:

      • Division of Public Health:
        • Early Hearing Detection and Intervention (EHDI)
        • Infant Toddler
        • Sickle Cell

      • Office of Rural Health and Community Care
        • Community Care of NC – Uninsured Parents (CCNC-UP)
        • Healthnet (encounter data only: no claims will be paid
  • What improvements for providers are you anticipating from this new system?
    Some of the improvements providers will experience are:
    • Improved access to online provider training
    • Claims processing occurs multiple times each day
    • Reduced administrative burden through paperless commerce
    • Support for e-Prescribing
    • Use of Electronic signature for enrollment submissions
    • Use of a Provider Portal
    • Improved response to inquiries
    • Claim detail lines are no longer limited in number
    • Ability to submit a single claim for services paid by multiple health plans.
  • What features will be available in the new NCTracks Provider Portal?
    The new NCTracks Provider Portal has been carefully designed with ease of use and productivity in mind. Some of the key features available to you will be:
    • The ability to receive announcements relating to key program or process changes
    • An inbox for receipt of personalized messages in a secure mailbox
    • Enhanced functionality that will allow you to more efficiently manage changes, update provider records, add services to a location, participate in electronic communications and list serves as well as manage affiliations to billers, groups and organizations.
    • Automation of the Prior Authorization process
    • Checking recipient eligibility
    • Checkwrite information
    • Remittance Advices on-line
  • What is the expected impact of the new system on my organization?
    NCTracks will provide efficiencies and changes to claim submission which do not exist in the Legacy MMIS+ . However, as with any new system, providers should take advantage of training opportunities to learn the features and operation of NCTracks. Training schedules will be published in the months approaching the July 2013 go live date.

    Providers of DMH/DD/SAS State-funded services will continue to contact their contracted LME.
  • What efficiencies will I gain from using the NCTracks Provider Portal?
    Once in the Provider Portal, providers will have the ability to:

    • Perform provider enrollment and maintenance functions;

    • Inquire on recipient eligibility and enrollment*;

    • Submit original claims, claim adjustments and prior approval requests*;

    • Review claims payment and status information*;

    • Access Prior approval requests*;

    • Access State-approved forms;

    • Access provider training information including provider workshop

    • Registration, training materials, training evaluation forms, bulletins, broadcast emails, supporting documentation for training; and

    • Enter registration to receive notifications and/or facilitate

    • Communications appropriate to each DHHS division and health plan supported by NCTracks.


    *Providers of DMH/DD/SAS State-funded services will continue to contact their contracted LME.
  • Will the current EDI agreement suffice for all electronic transactions? new
    No, the current EDI agreements will not be valid for NCTracks. It is anticipated that new trading partner agreements will need to be completed.
  • Who in my organization needs to have an NCID?
    All staff that will be provisioned to access a provider's record, training or have view or update rights to the record will need to acquire an NCID.
  • Is there a limit to the number of staff in my organization who can utilize the NCTracks Provider Portal?
    No. As long as the staff requiring access has an NCID, there is no limit to the number of staff who can access the provider portal. DMH/DD/SAS) providers will not have access to the provider web portal.
  • How will access to the various functions within the NCTracks Provider Portal be managed?
    You will designate an Administrator of the NCTracks Provider Portal who will be assigned a PIN for set up of staff access. Your Administrator will be the only one who can actually customize the NCTracks Provider Portal access for each staff member.
  • What are some examples of how business processes might change?
    One of the most significant changes and one that will increase the efficiency of claims submission is the multi-payer features of the new system, NCTracks. Providers no longer need to submit separate claims for each health plan. A single claim will process using the most appropriate payer and benefit plan and report on the providers’ remittance advices.

    The LMEs will continue to submit claims for those DMH/DD/SAS providers endorsed by a LME.
  • How will the State of North Carolina help providers get ready for the new system, NCTracks?
    The State is fully committed to ensuring all providers have multiple opportunities to learn about the features of the new NCTracks system. Please watch for informative messages describing new features and ways to prepare for the changes on the OMMISS website http://ncmmis.ncdhhs.gov.

  • After go-live, how and where will my staff be able to submit questions on technical or other issues we discover after using the system?
    Our Fiscal Agent, CSC, will have trained staff in their provider call center and technical help desks to resolve issues. The hours of availability will be:

    Pharmacy Prior Approval Call Center
    6:00 a.m. to 11:00 p.m. EST, Monday through Friday;
    7:00 a.m. to 7:00 p.m. EST Saturday and Sunday.
    Non-Pharmacy Customer Service Center & Technical Help Desk
    7:00 a.m. to 7:00 p.m. EST, Monday through Friday;
    8:00 a.m. to 5:00 p.m. EST Saturday
  • What support can I expect during the initial go live period?
    The new Fiscal Agent, CSC, will have staff trained on the new system as well as State policies available to providers. The provider web portal will also provide more information than today, and the real time claims processing feature will enable you to see results very soon after submission of claims, rather than waiting for weekly cycles to process.

    Providers of DMH/DD/SAS State-funded services will continue to contact their contracted LME.
  • How will my needs for support from the call center change?
    While CSC will staff a call center to answer typical questions from providers and recipients, NCTracks Provider Portal and Recipient Portals will permit individuals to obtain information and perform functions without guidance from the call center agents. For example, providers can obtain claims status, submit claim adjustments and request updates to demographic data in the enrollment file. Recipients can check on covered benefits and verify status of premium payments (NC Health Choice).
  • Will local setup and configuration be needed before we can use the NCTracks Provider Portal?
    The NCTracks Provider Portal is web based, and requires no locally installed software or other special configuration. Most commercially available browsers may be used to access the portal features.
  • What is the cut-over schedule for the go live transition from the legacy MMIS system to NCTracks?
    Check the OMMISS website (http://ncmmis.ncdhhs.gov) at a later date for additional information.
  • How can I make the implementation successful for my organization?
    Be involved in the process!! Check the OMMISS website regularly at http://ncmmis.ncdhhs.gov. If you are interested in participating in testing, submit a request to OMMISS.ProviderRelations@dhhs.nc.gov. Please include the provider name, contact name, email address and phone number and include "Testing Participation" in the subject line.

    Training is a key factor in your organization’s success! Watch for the training schedule in 2012 on the OMMISS website at http://ncmmis.ncdhhs.gov/faq.asp#training.

    Providers of DMH/DD/SAS State-funded services will continue to contact their contracted LME.
  • Where can I find information and resources on NCTracks?
    For more information about NCTracks, please check the OMMISS Features and Benefits page at http://ncmmis.ncdhhs.gov/benefits.asp. Updates to the project, FAQs and training information will be posted at http://ncmmis.ncdhhs.gov/.
  • How can I automatically receive updates regarding the NCTracks installation?
    You can automatically receive updates by logging into the Contact Us page at http://ncmmis.ncdhhs.gov/contact.asp. Complete the "Provider Email Distribution List" section. Upon receipt, we will add your email address to our distribution list and send you monthly updates with links to communications.

    We also send communications to your Association for distribution to their membership. Providers of DMH/DD/SAS State-funded services will continue to contact their contracted LME.

Claims

  1. Is there an online edit capability in place for providers to correct errors before and after adjudication? new
  2. Will CSC be responsible for Crime Victims payments? new
  3. If claims are in process at the time of the transition, will they be converted to the NCTracks system?
  4. How will the prior claims history be accessed?
  5. How can I adjust a claim that was processed in the Legacy MMIS+ prior to NCTracks implementation?
  6. Will CSC allow 276/277 transactions through an outside vendor such as MedData (automatic), and not just checking claim status via a web portal (manual)? new
  7. Will NCTracks reject an entire batch for individual claim errors? new
  8. Will claims be rejected at the claim level or batch level? new
  9. Will each claim sequence through all edits before being denied or rejected? new
  10. Will the claim list all denial codes when a claim is denied rather than for only one reason at a time? new
  11. Will there be an online comprehensive denial code listing? new
  12. Will I be able to view claim payment status online?
  13. Can we download files for claims status (pending, rejected, in process) for posting to the core system? new
  14. Can I adjust my claims on-line?
  15. Can the provider see pends online and fix them online so they will pay (if adjudicated prior to a checkwrite)?
  16. Will the providers be able to obtain a list of pending claims by NPI/Taxonomy or Group number from the NCTracks Provider Portal and by Batch? new
  17. Can I print a copy of my submitted claim(s) from NCTracks? new
  18. How often will payments be issued? new
  19. Will NCTracks make claims payments by EFT and by check? new
  20. For the data element TPL amount, is this the amount the provider submitted on an 837 or is this the Medicaid calculated amount (up to payable charge)?
  21. Can Medicaid secondary claims be filed electronically when Medicare HMO is primary? new
  22. Will all claims be processed electronically (e.g., claims with special diagnosis codes are required to go to paper in order to pay)? new
  23. If I send my electronic claims via a practice management system, do I have to do anything differently when submitting electronic claims after the system change?
  24. When can I submit a paper claim?
  25. How will the NCCI (National Correct Coding Initiative) and MUE (Medically Unlikely Edits) be impacted by the transition?
  26. What changes will there be in the services covered?
  27. Will CRNA services continue to be filed on a professional claim? new
  28. Can you explain how addtional documentation is submitted for an 837? new
  29. How will NCTracks improve the efficiency of prior approval requests?
  30. How will I know if my prior authorization or managed care override request has been approved?
  31. What is the PA confirmation number?
  32. Will we be able to create referrals?
  33. Will we be able to check status of referrals?
  34. When will I be required to use ICD-10 codes?
  35. What are the requirements for use of ICD-10 codes?
  36. At the point of transition to ICD-10, what will happen to claims in process with an ICD-9 code?

 

  • Is there an online edit capability in place for providers to correct errors before and after adjudication? new
    NCTracks will permit a provider to submit an adjusted claim from a fully processed historical claim. However, the system does not permit correction of errors as claims process.
  • Will CSC be responsible for Crime Victims payments? new
    No.
  • If claims are in process at the time of the transition, will they be converted to the NCTracks system?
    Legacy claims systems will deny in-process claims and adjustments at the end of the last checkwrite cycle. Providers will be required to resubmit them in NCTracks after it goes live on July 1, 2013. Providers will be notified with the Explanation of Benefits (EOB) statements below:
    • For pended claims – Due to the NC DHHS transition for Replacement MMIS, NCTracks, your claim did not complete adjudication and you will need to resubmit your claim to NCTracks on or after July 1, 2013.

    • For pended adjustments – Due to the NC DHHS transition for Replacement MMIS, NCTracks, your adjustment did not complete adjudication; you will need to resubmit your claim to NCTracks on or after July 1, 2013.

  • How will the prior claims history be accessed?
    NCTracks will have 10 years of prior historical claims history; 5 years will be visible and 5 years will be archived.
  • How can I adjust a claim that was processed in the Legacy MMIS+ prior to NCTracks implementation?
    Claims history from the Legacy MMIS+ will be available in NCTracks. This will allow you to adjust claims originally processed in the Legacy MMIS+ using the NCTracks Provider Portal or submission of a HIPAA 5010 837 batch file.

    For DMH/DD/SAS providers, only the LMEs (Local Management Entities) will have access to adjust claims on-line.
  • Will CSC allow 276/277 transactions through an outside vendor such as MedData (automatic), and not just checking claim status via a web portal (manual)? new
    Yes.
  • Will NCTracks reject an entire batch for individual claim errors? new
    No, however, if the X12 structure for compliance (segments, loop, etc) fails, the entire file will be rejected.
  • Will claims be rejected at the claim level or batch level? new
    Claims could be rejected at both levels.
  • Will each claim sequence through all edits before being denied or rejected? new
    Yes, unless the claim fails a critical validation, the claim will be subjected to all applicable edits. All failed edits will be returned to the provider on the Remittance Advice.
  • Will the claim list all denial codes when a claim is denied rather than for only one reason at a time? new
    Claims will be edited as completely as possible. There are instances where full editing will not be possible; an example of this is when the submitted Recipient ID is not on file. Without this critical data element, all recipient-based editing would be bypassed.
  • Will there be an online comprehensive denial code listing? new
    Yes.
  • Will I be able to view claim payment status online?
    Providers will have access to electronic views of their remittance reports via the secure NCTracks Provider Portal. Providers will also be able to inquire online regarding payment status from multiple payers (DMA, DMH/DD/SAS, DPH, and ORHCC).

    For DMH/DD/SAS providers, only the LMEs (Local Management Entities) will have access to the NCTracks Provider Portal.
  • Can we download files for claims status (pending, rejected, in process) for posting to the core system? new
    Yes, a corresponding 277 batch response (i.e., paid, denied and pended claims) file will be produced for posting to an external system. If a claim transaction is rejected upfront for format issues and a negative 997 returned, the 276 request for that claim would show "claim not found" on the 277 response.
  • Can I adjust my claims on-line?
    Yes. You will be able to submit an adjustment through the NCTracks Provider Portal or via an 837 batch file. For DMH/DD/SAS providers, only the LMEs (Local Management Entities) will have access to adjust claims on-line. Detailed information on this process will be provided at a later date.
  • Can the provider see pends online and fix them online so they will pay (if adjudicated prior to a checkwrite)?
    Pended claims will be reported separately on the "Pend Claims Remittance" portion of the RA.
    Providers will be able to see which claims have pended using the NCTracks Provider Portal or the AVRS. The pended claims cannot be fixed by the provider online, but the provider could void and resubmit the claim before the checkwrite and, assuming the reason for the pend was resolved, and no other edits cause a denial, the claim would be paid in that checkwrite.
  • Will the providers be able to obtain a list of pending claims by NPI/Taxonomy or Group number from the NCTracks Provider Portal and by Batch? new
    No.
  • Can I print a copy of my submitted claim(s) from NCTracks? new
    Yes, users of the NCTracks Provider Portal will be able to produce screen prints of the claim entry pages.
  • How often will payments be issued? new
    Payments will be issued via EFT according to the checkwrite cycle approved by the State.
  • Will NCTracks make claims payments by EFT and by check? new
    No, claim payments will only be made via EFT and not by check.
  • For the data element TPL amount, is this the amount the provider submitted on an 837 or is this the Medicaid calculated amount (up to payable charge)?
    NCTracks will receive the TPL Submitted amount on the 837. During the adjudication process, the TPL Applied amount will be calculated and will beused to calculate the Claims Reimbursement Amount. The RA will report the TPL Applied amount.
  • Can Medicaid secondary claims be filed electronically when Medicare HMO is primary? new
    Yes, NCTracks will accept electronic crossover claims from the Medicare COBC.
  • Will all claims be processed electronically (e.g., claims with special diagnosis codes are required to go to paper in order to pay)? new
    Yes, there are no limitations on the types of claims that can be submitted electronically.
  • If I send my electronic claims via a practice management system, do I have to do anything differently when submitting electronic claims after the system change?
    Companion guides, testing procedures and process definitions will be developed and sent at a later date.
  • When can I submit a paper claim?
    Beginning in 2009, State legislation required claims be submitted electronically. The OMMISS website (http://ncmmis.ncdhhs.gov/) will list any exceptions to that rule at a later date.
  • How will the NCCI (National Correct Coding Initiative) and MUE (Medically Unlikely Edits) be impacted by the transition?
    The NCCI edits and MUEs will be included in the NCTracks adjudication system and applied to all incoming claims in a manner consistent with current MMIS processing.
  • What changes will there be in the services covered?
    There will not be any changes in the services covered unless mandated by the legislature. Changes to services covered will be communicated by DMA and posted on their website at http://www.ncdhhs.gov/dma/provider/index.htm.
  • Will CRNA services continue to be filed on a professional claim? new
    Yes, CRNA services will continue to be filed on a professional claim.
  • Can you explain how addtional documentation is submitted for an 837? new
    On the 837 claim, the attachment control number (ACN) must be populated on any accompanying fax or mailed documentation. Once the documentation is sent, the ACN will be used to match to the claim. The fax and mail documentation will be stored in the image repositiory. Specific instructions will be provided during training.
  • How will NCTracks improve the efficiency of prior approval requests?
    Providers will be able to create and submit most PA requests with attachments as electronic documents, as required, via the NCTracks Provider Portal. Providers will also have the ability to determine if a specific service or procedure requires prior approval. Additional information to follow on enhanced functionality.

    For DMH/DD/SAS providers, only the LMEs (Local Management Entities) will have access to submit prior authorizations on-line.
  • How will I know if my prior authorization or managed care override request has been approved?
    Once a decision is reached on a prior authorization or managed care override request, an email will be sent to the provider at the office email address provided. Providers will be able to inquire on a prior approval and managed care override request via the NCTracks Provider Portal regardless of how the request was submitted. Many types of prior approval requests, particularly pharmacy requests, can be immediately approved by the NCTracks system. This means that the provider can receive an immediate approval when a request is received by phone or via the NCTracks Provider Portal.

    DMH/DD/SAS providers will contact the LME (Local Management Entity) for prior authorization requests.
  • What is the PA confirmation number?
    The PA confirmation number is the number providers will receive to indicate that a prior approval request was successfully submitted to NCTracks. This number can be used to inquire on the status of a request via the NCTracks Provider Portal, or when calling fiscal agent staff to discuss a request.
  • Will we be able to create referrals?
    Providers will be able to create managed care referrals via the NCTracks Provider Portal.

    DMH/DD/SAS providers will submit referrals to the LME (Local Management Entity).
  • Will we be able to check status of referrals?
    Providers will be able to check the status of managed care referrals via the NCTracks Provider Portal.

    DMH/DD/SAS providers will need to check with their LME (Local Management Entity) on the status of referrals.
  • When will I be required to use ICD-10 codes?
    ICD-10 codes must be used on all HIPAA transactions, including outpatient claims with dates of service, and inpatient claims with dates of discharge on and after October 1, 2013.
  • What are the requirements for use of ICD-10 codes?
    You can view the CMS requirements (http://www.cms.gov/ICD10).

    Detailed information regarding use of ICD-10 will be posted at a later date on the DMA website (http://www.ncdhhs.gov/dma/).
  • At the point of transition to ICD-10, what will happen to claims in process with an ICD-9 code?
    Claims with service dates prior to October 1, 2013 will continue to be processed with the ICD-9 codes.

Remittance Advice/EOB

  1. Will providers be able to access remittance advices (RAs) online after go-live?
  2. Will additional remark codes be provided? new
  3. Will the paper (EOB) remark codes be provided within the 835? new
  4. Will there be a glossary of new terminology and field names that will appear on the NCTracks Remittance Advice and status reports?
  5. On the NCTracks RA, does the data element Transaction Claim Number (TCN) map to the claim number on the paper RA?
  6. Can the proprietary EOB’s be mapped specifically to HIPAA remark codes and can they be mapped to multiple remark codes?
  7. Will there be line item detail by service date on the RA?
  8. How will the Carolina ACCESS management fees appear on the Remittance Advice?
  9. Will CRNA services continue to appear in the professional claim section of the RA? update
  10. How will the Health Check fees appear on the Remittance Advice?
  11. In Legacy, certain claims that cannot be processed through the MMIS are processed as Financial Items.  The information on the current RA about these transactions is usually just the recipient ID number and part of the name and maybe a date of service.  Will the “financial transactions” on the NCTracks RA represent the same thing as the “financial items” on the Legacy RA?
  12. Are the EOB’s used to report the disposition of the claims at the detail level the same ones that appear on the “EOB page”?
  13. Are the denied/non-covered charges listed separately on the RA reports? For example, a claim is adjudicated with some details having paid, one detail having been denied because of a problem with a PA, or procedure code, etc., and one detail having been denied because it is a non-covered service.
  14. Will providers have sort or report writer functionality for EOB’s in NCTracks?
  15. What other changes will be made to the Remittance Advice?

 

  • Will providers be able to access remittance advices (RAs) online after go-live?
    Yes, remittance advices will be stored in the NCTracks Provider Portal for viewing and download, if so desired. The NCTracks Provider Portal will also produce the 835 transaction file.
  • Will additional remark codes be provided? new
    Yes, the 835 transaction requires that HIPAA standard remark codes be included.
  • Will the paper (EOB) remark codes be provided within the 835? new
    No.
  • Will there be a glossary of new terminology and field names that will appear on the NCTracks Remittance Advice and status reports?
    The definition of any new terminology and/or field names associated with the NCTracks RA will be provided as part of the Provider Training delivered by CSC.
  • On the NCTracks RA, does the data element Transaction Claim Number (TCN) map to the claim number on the paper RA?
    Yes.
  • Can the proprietary EOB’s be mapped specifically to HIPAA remark codes and can they be mapped to multiple remark codes?
    Each edit in the new system will map to only one proprietary EOB. The EOBs can be mapped to the HIPAA remark codes. There is not, however, a 1:1 relationship between HIPAA remark codes and proprietary EOBs.
  • Will there be line item detail by service date on the RA?
    Yes, line item detail by service dates are reported on the Remittance Advice.
  • How will the Carolina ACCESS management fees appear on the Remittance Advice?
    There will be a separate RA section for Carolina ACCESS Management Fees which will include:

    • Dates of Service

    • Rate Cohort code and description

    • Paid Amount

    • Number of Claims

  • Will CRNA services continue to appear in the professional claim section of the RA? update
    Yes.
  • How will the Health Check fees appear on the Remittance Advice?
    Health Check claim details will be reported on Professional Claims Layout section of the RA. Procedure Code, Description, Total Units, Total Billed , Total allowed, Paid amounts, and EOB code will be reported in the Professional Claim section of the R.A.

    There will be a separate RA section for Health Check fees which will include:

    • Dates of Service

    • Rate Cohort code and description

    • Number of Claims

    • Paid Amount

  • In Legacy, certain claims that cannot be processed through the MMIS are processed as Financial Items.  The information on the current RA about these transactions is usually just the recipient ID number and part of the name and maybe a date of service.  Will the “financial transactions” on the NCTracks RA represent the same thing as the “financial items” on the Legacy RA?
    The “financial transactions” on the NCTracks RA is similar to the “financial items” on the Legacy RA. However, the NC Tracks system will have functionality not in the Legacy MMIS+, and therefore more claims will be processed as claims versus older claims being processed as financial transactions.
  • Are the EOB’s used to report the disposition of the claims at the detail level the same ones that appear on the “EOB page”?
    Yes, the EOBs used to report the disposition of the claims at the detail level are the same ones that appear on the EOB summary page. The EOB summary page is the last page in the RA and lists EOB codes and definitions for all EOBs reported in the Remittance Report.
  • Are the denied/non-covered charges listed separately on the RA reports? For example, a claim is adjudicated with some details having paid, one detail having been denied because of a problem with a PA, or procedure code, etc., and one detail having been denied because it is a non-covered service.
    If at least one of the detailed lines is paid, the claim header status would reflect the paid status. However, all the detail lines will be reported on the R.A reports.

    The submitted charges on the denied line items will be reported but the reimbursement amount will be zero.

    Also each line item will have the EOB, edit, and HIPAA error codes which explain why the claim detail item is denied.

    Non-covered charges are also reflected at the detail level and a total is also provided.
  • Will providers have sort or report writer functionality for EOB’s in NCTracks?
    The system does not have sort or report writer capabilities for the RA or pended claims. The EOB summary page lists EOB codes and definitions for all EOBs reported in the RA.
  • What other changes will be made to the Remittance Advice?
    Check the OMMISS website http://ncmmis.ncdhhs.gov at a later date for additional information.

Testing

  1. When will the testing phase begin?
  2. How can I participate in the testing of the NCTracks system?
  3. How will my clearinghouse, third party vendor or billing agent be involved in the testing?update

 

  • When will the testing phase begin?
    Check the OMMISS website (http://ncmmis.ncdhhs.gov/) at a later date for additional information.
  • How can I participate in the testing of the NCTracks system?
    If you are interested in testing participation, you can send an email to: OMMISS.ProviderRelations@dhhs.nc.gov. Please include the name of the provider, a contact name and phone number. In the subject line of your email, specify ‘Testing Participation’.
  • How will my clearinghouse, third party vendor or billing agent be involved in the testing?update
    As part of trading partner certification, each trading partner will need to submit test transactions into NCTracks for valdation. Clearinghouses will be required to go thru trading partner certification.

    Check the OMMISS website (http://ncmmis.ncdhhs.gov/) at a later date for additional information.

Training

  1. How will my staff be trained on the new system?
  2. When will training be conducted?
  3. What are the locations for the regional instructor led training sessions?
  4. How many people from my office can attend a regional instructor led training session?
  5. Can my office staff attend multiple training sessions?
  6. How will entities that handle claims submission, payments and 835 transactions be trained on changes?
  7. If a provider is unable to attend a provider training, how can the training materials be obtained?
  8. What training resources will I have available subsequent to the regional instructor led training sessions?

 

  • How will my staff be trained on the new system?
    Training will be provided via instructor-led training sessions as well as CBT (Computer-Based Training). Additional information will be provided at a later date at http://ncmmis.ncdhhs.gov/.
  • When will training be conducted?
    The training schedule will be sent to all providers and posted on the OMMISS website (http://ncmmis.ncdhhs.gov/) at a later date.
  • What are the locations for the regional instructor led training sessions?
    Currently, we are planning to have regional instructor led training sessions in Charlotte, Raleigh/Durham, Greensboro, Wilmington and Asheville. Updated training information will be posted on the OMMISS website at http://ncmmis.ncdhhs.gov/.
  • How many people from my office can attend a regional instructor led training session?
    Training events, available seats and registration will be published in the NCTracks Provider Portal. Initially classes may be limited by provider site to ensure opportunities exist for many providers to be represented. Details on training schedule will be posted on the OMMISS website (http://ncmmis.ncdhhs.gov/) at a later date.
  • Can my office staff attend multiple training sessions?
    Yes. When classes are made available, your staff can enroll in training sessions through the training page in the NCTracks Provider Portal. Development of the training schedule is in progress and will be sent to all providers via the NCTracks Provider Portal and posted on the OMMISS website at http://ncmmis.ncdhhs.gov/.
  • How will entities that handle claims submission, payments and 835 transactions be trained on changes?
    Training sessions will be planned for all entities impacted by the replacement system. Check the OMMISS website (http://ncmmis.ncdhhs.gov/) at a later date for additional training information.
  • If a provider is unable to attend a provider training, how can the training materials be obtained?
    Providers will have the ability to download training materials from the Training site.
  • What training resources will I have available subsequent to the regional instructor led training sessions?
    Ongoing and refresher training will be provided. Web-based modules and downloadable supplemental training materials for the session will be available for a variety of topics including claims filing instructions, special areas of interest, and NCTracks training. Self-paced courses, provider manuals, bulletins, and training workshop schedules will all be available online.

Provider Enrollment

  1. Where can I find information on the current provider enrollment process?
  2. How do I enroll as a provider?
  3. Once enrolled as a provider, will I have to re-enroll?

 

  • Where can I find information on the current provider enrollment process?
    Check out current provider enrollment information at https://www.nctracks.nc.gov/provider/providerEnrollment/index.jsp.
  • How do I enroll as a provider?
    The NCTracks Provider Portal will provide a secure and convenient method to complete and submit initial provider enrollment applications.

    Providers will have the ability to complete all required fields on application web pages, electronically sign and submit the application. The electronic enrollment process also includes the option to upload supporting documents with the initial application. You can access the on line provider enrollment application at https://www.nctracks.nc.gov/provider/providerEnrollment/index.jsp
  • Once enrolled as a provider, will I have to re-enroll?
    Active in-state and border area providers will not be required to re-enroll. You will, however, need to be re-credentialed (checking your licenses, certifications, and endorsements) every 3 years.

    Additional enrollment information can be located at https://www.nctracks.nc.gov/provider/providerEnrollment/index.jsp

 

Additional questions about NCTracks?

If you don't see a response to your question(s) or if you need clarification on an FAQ response, please send an e-mail to Provider Relations (ommiss.ProviderRelations@dhhs.nc.gov). If you wish to receive an email notification of all NCTracks communications sent by OMMISS, please go to the Contact Us page and register under Provider Email Distribution List.

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