NCTracks Provider Data Collection FAQs

New information required for individual providers effective Aug. 9, 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)

This information will be collected on the Provider Supplemental Information page of Initial Enrollment, Re-verification, and Re-enrollment applications. 

This information will be collected via initial enrollment, re-enrollment and re-verification applications for individual providers effective Aug. 9, 2020. Providers who are currently enrolled do not need to do anything; this information will be collected in their next re-verification application (or re-enrollment application if they are terminated). 

NCTracks is collecting this additional information to assist in streamlining the data collection process for providers and Prepaid Health Plans (PHPs) to facilitate network eligibility determinations.

On Aug. 9, 2020, any enrollment, re-enrollment and re-verification applications that were in draft were deleted to allow for updates to the individual provider application process.

Yes, they are required on all applications including MCRs. No, this requirement is not changing; sanction questions will still be required in all applications including MCRs.

The new Provider Supplemental Information page will be required in Initial Enrollment, Re-verification and Re-enrollment applications only.

No, only individual providers (and excluding individual OOS Lite and Disaster Relief providers) will be required to supply this additional information.

Effective Aug. 9, 2020, additional supporting information may be required based on application responses or if your information is unable to be verified during the background check. Please see the link under Resources at the top right of this page for applicable additional information. As always, if you have answered “yes” to any of the provider sanction questions, at the end of the application you must upload or submit a complete copy of applicable documentation.

This new information will be required in initial enrollment, re-enrollment and re-verification applications for individual providers (excluding disaster relief and Out of State Lite providers) effective Aug. 9, 2020. These applications will contain the new Provider Supplemental Information page. For a complete overview of the changes, please see the link under Resources at the top right of this page. 

Currently enrolled providers are not required to supply this information until a re-enrollment or re-verification application is submitted.

If insufficient information is provided by the individual provider or in NCTracks’ background verification, a request for supporting documentation will be sent to the provider. 

The Upload Documents page will allow the provider to upload supporting documentation if necessary, such as copies of certifications. However, official transcripts should not be uploaded to the Upload Documents page. If applicable, the provider will receive instructions on where to send this documentation.

No, the malpractice insurance certificate is not required.

Please see the June 9, 2020 announcement New Information Required in Applications for Individual Providers Enrolling in Medicaid and NC Health Choice. This communication is also posted as a Medicaid Bulletin posted June 8, 2020 on the DHB webpage. Please also see the July 2, 2020 announcement, Details on New Information Required on Applications for Individual Providers.

For the most current updates including resources and training, please check back on the NCTracks website and read NCTracks email updates when available. To subscribe to NCTracks emails, click on the link under the heading “Sign Up for NCTracks Communications” on the NCTracks Provider Communications page or text NCTRACKS to 22828 and follow the prompts.

 

Training courses are available in July 2020 and are listed here. Further details and more resources will be announced on the Provider User Guides and Training page.

An example of the new supplemental Information page is linked under Resources at the top right of the page. This page will be before the Exclusion/Sanction questions.

In addition to entering required certifications, individual providers are now requested to add all board certifications.

If the enrolling provider is currently a resident or intern, when entering work history he/she should enter the details of that residency/internship, such as:

Job Title: Resident

Company Name: Healthcare Facility XYZ

Start Date:  Date residency/internship began

End Date: 12/31/9999 if still a resident/intern

Accreditations may be added to the NCTracks provider record by submitting a Manage Change Request (MCR).

Please contact https://www.jointcommission.org/

Malpractice insurance information provided on an application may not be updated by completing a Manage Change Request (MCR). If the information provided on this page needs to be updated, the provider must update or correct it the next time they complete a re-verification application, or if they are terminated, when they re-enroll. Providers are encouraged to make sure their information is properly submitted to NCTracks.

Please visit the website https://www.dea.gov/

North Carolina does not require CDS. DEA is sufficient if you are a prescribing provider. 

General information such as licenses and accreditations may be updated in NCTracks by submitting a Manage Change Request (MCR). Log into the NCTracks Secure Provider Portal to complete an MCR to update your information. However, the information provided on the Provider Supplemental Information page may not be updated by completing an MCR. If the information provided on this page is inaccurate, the provider must correct it the next time they complete a re-verification application, or if they are terminated, when they re-enroll. Providers are encouraged to make sure their information is properly submitted to NCTracks.

If the employer for all the practices is Rex, it is fine to just show Rex and the date initially started. They do not have to show the different locations.

The effective date is 8/9/2020.  The additional fields/application updates will not be present before then to complete.  You may go ahead and enter applications now; they will be processed without the new information required if entered prior to the implementation date of 8/9/2020.

You should list the employer name and date of hire.

When a provider enters their work history on an Initial or Re-enrollment Application, if there is a gap of six months or more between any jobs, the provider must write, sign* and date an explanation of the gap in work history and then upload the document to the Upload Documents page in the application. This only needs to be submitted once for an enrolling provider; it will not be required for re-verification applications (unless there is a new gap of six months or more since a previous Initial or Re-enrollment application).

*Note: For the work history gap explanation, faxed, digital, electronic, scanned or photocopied signatures are acceptable, but signature stamps are NOT permitted.

Yes, the PHPs need this information in order to establish their networks and determine quality.

As a result of the data conversion from the previous system, some licensing, accreditations or certifications may appear on the record that are not required by the taxonomy, or duplicate/partial information will display. If you have one of these unrequired credentials on your provider record, you should remove it from your record to prevent any issues with your applications.

Effective Aug. 9, 2020, there will be an option available for the provider to select that a license, accreditation or certification is invalid, allowing the provider to remove it using a full Manage Change Request (MCR) (select “multiple changes” when opening a new MCR). This will help prevent any issues with your application going forward. Providers may also mark licenses invalid during a re-verification application (accreditations and certifications will not display, only licenses).

Providers should list their current employment in this history with the applicable start date and an end date of 12/31/9999 (regardless of anticipated end date). Initial Enrollment, Re-enrollment and Re-verification applications require at least one employment entry with this end date.

If the enrolling provider is currently a resident or intern, when entering work history he/she should enter the details of that residency/internship, such as:

Job Title: Resident

Company Name: Healthcare Facility XYZ

Start Date: Date residency/internship began

End Date: 12/31/9999 if still a resident/intern

Providers should list their current employment in this history with the applicable start date and an end date of 12/31/9999 (regardless of anticipated end date). These application types require at least one employment entry with this end date.

Providers who have already completed one of these applications and did not list their current employment with an end date of 12/31/9999 will not be affected, but should enter this at their next re-verification (or re-enrollment if terminated).

Providers should not upload their school transcripts or residency verification letters. If requested, providers should contact their school/residency program and request them to mail or email the official transcript/residency verification to NCTracks. The email address will be provided in the returned application letter. The mailing address is:

Provider Enrollment

PO Box 300009

Raleigh, NC 27622

Due to the potential delay depending on medical or professional schools returning the transcripts/residency program verification, an adjusted time frame will be offered for applications in this circumstance. Providers will initially have 30 days to submit the transcript/residency verification. If NCTracks does not receive it within 30 days, another 30-day notice will be sent requesting the transcript/residency verification, prompting the provider to follow up. This will allow a total of 60 days for receipt of the documentation. If the transcript/residency verification has not been received within 60 days, the application will be abandoned and the provider must resubmit the application and pay all applicable fees.

If the school is unable to electronically send the transcript/residency verification to the secure email address, request the school send a sealed copy to the following address:

Provider Enrollment

PO Box 300009

Raleigh, NC 27622

If you are currently completing your residency, the residency information should be entered in the work history section. You should apply for the taxonomy designating you are a student (390200000X - Student Health Care) with a resident training license and enter “RTL” in the license number field.

If you have completed your residency, this information should be entered in the education section. You should select the taxonomy in your area of specialization and enter your full license information in the license number field.

Effective Oct. 12, 2020, for individual providers who have completed their residency and are completing an Initial, Re-Verification or Re-Enrollment Application, NCTracks also accepts verification letters directly from residency programs in place of medical school transcripts.  Transcripts will still be accepted for those without completed residencies, but the individual should submit residency verification if they have it. Similar to a transcript, the residency verification letter must come directly from the program. Residents cannot upload this letter or send it themselves; they must request the residency program send it to NCTracks directly by mail (Provider Enrollment, PO Box 300009, Raleigh, NC 27622) or email to the secure email address which will also be provided in the Request for Additional Information Letter. The medical or professional school transcript should only be submitted if residency was not completed.

NCTracks accepts a variety of residency verification; it may be a residency transcript, verification letter or residency certification.

If you are currently completing your residency, the residency information should be entered in the work history section. You should apply for the taxonomy designating you are a student (390200000X - Student Health Care) with a resident training license and enter “RTL” in the license number field.

If you have completed your residency, this information should be entered in the education section. You should select the taxonomy in your area of specialization and enter your full license information in the license number field.

Certain providers (based on provider type) must have a DEA certification. Please refer to the Provider Permission Matrix (PPM) under Quick Links on the Provider Enrollment page to determine if you are affected. Please see the Details on Prescribing Provider DEA Requirements communication for more details.

If a provider designated as a prescriber on the Provider Permission Matrix does not have a DEA certificate number, they must:

1. Enter 123456789 as the DEA certificate  number.

2. Complete the DEA Designation Form (found on the Provider Policies, Manuals, Guidelines and Forms page under Provider Forms) indicating the reason for not having a DEA certification, selecting one of the following reasons on the form:

• The prescribing provider is currently working on obtaining their DEA certification (it is in process or is still pending). They must elect a temporary alternate prescriber to write prescriptions for controlled substances on their behalf until they have a valid certification. The form must be completed providing the alternate prescriber’s information.
• The prescribing provider elects not to prescribe controlled substances themselves but prescribing controlled substances is in their scope of practice. They must identify another doctor to write these prescriptions on their behalf. The form must be completed providing the alternate prescriber’s information.
• The prescribing provider does not prescribe or refer prescriptions for controlled substances because they believe their patients do not require controlled substances. In this circumstance, the provider must sign the statement on the form indicating this and describe their process for handling instances when a patient requires a controlled substance.

3. Upload the  form to the Upload Documents page under Status Management when submitting an application.

 

Future  communications will provide additional information. Providers are encouraged to check their email and NCTracks provider announcements regularly.

The DEA Designation Form can be found on the Provider Policies, Manuals, Guidelines and Forms page under Provider Forms.

Upload this form to the Upload Documents page under Status Management when submitting an application.

 NCTracks will automatically verify the DEA certification number. If the name and DEA certification number on the application match the information on file with DEA, the application will continue processing. If the  information does not match, the provider will receive an Application Incomplete letter detailing actions required to resolve the mismatch.

Prescribing providers have been required to provide their DEA certification number on Initial Enrollment, Re-enrollment or Manage Change Request (MCR) applications since Oct. 1, 2020.