Common Enrollment Application Issues FAQs

Supporting documentation is required in the following circumstances*:

• One or more sanction/exclusion question was answered “yes”
• You are missing six or more months of work history
• You are applying for a taxonomy that requires additional documentation (requirements are listed in the Provider Permission Matrix under Quick Links on the Provider Enrollment page)

The only item that must be uploaded by all providers is the Individual Agreement, which must be downloaded and signed by the provider and then uploaded.

Supporting documentation (including the Individual Agreement) is uploaded after clicking the Submit button on the application, which takes the provider to the Final Steps Page. On the Final Steps page (and the Status and Management page), there is a hyperlink to the Upload Documents page. Providers are able to upload supporting documents there.

Please note that malpractice judgement or settlement documentation and transcripts should not be uploaded to the Upload Documents page. If required, a request will be sent for this information with instructions on how to submit this documentation.

*Additional supporting information may be required based on application responses. Please see the the link under Resources at the top right of this page for applicable additional information.

The name on the application should match the National Plan and Provider Enumeration System (NPPES) National Provider Identifier (NPI).

If a provider has paid the federal fee on a previous application and/or completed a federal site visit but that application was denied, they can avoid doing so again when submitting a new/second application. Providers should indicate they have already paid the fee and/or completed the site visit following the process of providing adequate proof outlined below.

When the provider comes to the page in the application with the questions “Have you paid the Federal Fee for this site within the past 12 months to another state or Medicare?” and “Have you completed the Federal site visit for this site within the past 12 months to another state or Medicare?” the provider should answer each question as follows as applicable:

1. Select ‘Other State’
2. Select ‘North Carolina’ from State drop down menu
3. Attach federal fee payment confirmation from the previous application
4. Attach documentation from PCG of completed and passed site visit and/or a letter identifying the enrollment application the site visit was passed for and on what date.

The Exclusion Sanction questions must be answered. All convictions (misdemeanors and felonies) must be disclosed regardless of how old the conviction is. (The only exception to this requirement is minor traffic offenses, such as a speeding ticket, expired registration, etc.) The questions must be answered for the enrolling provider, owners and agents in accordance with 42 CFR 455.100; 101; 104; 106 and 42 CFR 1002.3. If the answer to the Exclusion Sanction questions is “yes,” then documentation regarding the disposition of the action must be attached to the application. If a provider submits a written attestation, it must be on company letterhead and signed and dated by the person to whom the attestation applies. For a complete list of questions, go to the Provider User Guides and Training page of the NCTracks Provider Portal and open either the "How to Enroll in North Carolina Medicaid as an Individual Practitioner" or "How to Enroll in North Carolina Medicaid as an Organization” user guides, which are located in the Enrollment and Re-Verification section. These documents contain the list of sanction questions. Please note that effective July 26, 2020, additional exclusion sanction questions will be added to initial enrollment, re-enrollment, re-verification applications and manage change requests (MCRs) for individual providers (excluding disaster relief and Out of State Lite providers).

The form must be signed and dated by each person required to submit fingerprints. It must also be signed and dated by the law enforcement agency collecting the fingerprints. Providers must upload the Release of Information Form in NCTracks by the deadline on the notification letter.

No, do not mail it to the address on the evidence form. If the applicant opts to do a Fingerprint Card, it must be mailed to the State Bureau of Investigation (SBI) for processing at NCSBI/Applicant Unit, 3320 Garner Road, Raleigh, NC 27626.

The taxonomy code selected must accurately reflect the type of provider. The provider must meet the enrollment qualifications for the taxonomy code selected and possess the required licensure and/or credentials. Providers who are uncertain which taxonomy code to select should consult the “Provider Permission Matrix” (and instruction sheet) on the Provider Enrollment page of the NCTracks provider portal. For additional guidance, refer to “How to View and Update Taxonomy on the Provider Profile in NCTracks” on the Provider User Guides and Training page of the NCTracks provider portal.

This continues to be an issue on applications and may result in adverse action on the provider’s application and record. Refer to the article, Using NCIDs Properly in NCTracks, in the December 2016 Medicaid Bulletin.

This continues to be an issue which impacts the integrity of the application and Participation Agreement and may result in adverse action on the application. Ensure the accuracy of all information before the application is submitted.

Supporting documentation (including the Individual Agreement) is uploaded after clicking the Submit button on the application, which takes the provider to the Final Steps page. On the Final Steps page (and the Status and Management page), there is a hyperlink to the Upload Documents page. Providers are able to upload supporting documents there.

For more guidance on how to attach supporting documentation, refer to section 3.30.1 of Participant User Guide PRV111 Provider Web Portal Applications on the secure NCTracks provider portal.

Effective July 26, 2020, individual providers completing an application will be required to physically sign and upload an Individual Agreement themselves; the office administrator (OA) cannot complete this for them. This will be accessible through two locations within the provider record, the Final Steps page and the Upload Documents page.

On July 26, 2020, any enrollment, re-enrollment and/or re-verification applications that were in draft were deleted to allow for updates to the individual provider application process.

New information required for individual providers effective July 26, 2020 includes:

• Highest level of education
• Malpractice insurance (coverage type and amount)
• Health care-related work history (past five years, and if there is more than six-month gap, explanation of gap)
• Malpractice settlement history (past five years)
• Any conditions that might impact ability to perform job duties 

Additionally, individual providers completing the application will be required to physically sign and upload an Individual Agreement themselves; the office administrator (OA) cannot complete this for them. This will be accessible through two locations within the provider record, the Final Steps page and the Upload Documents page.