NCTracks Updates for Patient Monthly Liability

Effective October 29, 2017, the NC Department of Health and Human Services will update NCTracks to reflect the revisions to the NC Medicaid business rules regarding systematic adjustments and patient monthly liability (PML) processing. PML applies to specific types of claims, including inpatient hospital claims, skilled nursing facility claims and hospice claims.

The PML to be applied to a claim will be the lesser of the PML remaining balance for the month or the PML amount submitted on the claim, but will not exceed the Medicaid allowable amount. The PML remaining balance reflects the PML applied for claims already paid in the current service month.

Providers with questions can contact the CSRA Call Center at 1-800-688-6696 (phone), 1-855-710-1965 (fax), or NCTracksprovider@nctracks.com (email).