New Features for Voided Prior Approval Requests

A Prior Approval (PA) request may be voided in NCTracks for several reasons, including incorrect PA type, exact duplicate of an existing PA, and recipient not being eligible for the requested service dates. Beginning October 29, 2017, the reason a PA request was voided will be available on the secure NCTracks provider portal. The void description will be located in the details of a PA inquiry performed through the provider portal. The void description will help providers understand why the PA request was voided, so they can determine how to proceed. In some cases, the reason for the void may be correctable through submission of a new PA request.

For guidance on performing PA inquiry on the NCTracks provider portal, refer to “How to Determine the Status of Pharmacy PAs” under Prior Approval on the Provider User Guides and Training page of the NCTracks provider portal. (The instructions apply to all types of PA submitted to NCTracks.)

In addition, per Division of Medical Assistance policy, PA is not required when the recipient has Medicare as the primary insurance. Historically, PA requests submitted for Medicare primary recipients have been denied. Beginning October 30, these requests will be voided. A new letter will be generated to inform the provider that the request was voided because the recipient has Medicare as the primary insurance and the options for the provider/recipient to receive approval for the service. The letter will be posted on the Message Center Inbox of the secure NCTracks provider portal.