Guidance Regarding Change of Ownership (CHOW)
For providers who are or will be undergoing a Change of Ownership (CHOW), we recommend the following guidelines.
The new owner is encouraged to obtain a new NPI and enroll with that new NPI, rather than attempting to transfer the previous owner’s NPI. Attempting to end date the previous owner’s NPI and enroll using the same NPI may cause complications which can lead to denial of claims and prior approval requests.
Accordingly, providers are encouraged to do the following:
- The new owner should request a new NPI from NPPES and a new Tax Identification Number (TIN).
- Once the new owner receives the new NPI and TIN, they should enroll that new NPI in NCTracks via an initial enrollment application. (Please note that it may take up to 30 days for the new NPI to transfer from the NPPES database and appear in NCTracks).
- The new owner may complete an enrollment application as much as 365 days in advance of the effective date of the CHOW.
- Completing the application in advance of the CHOW effective date allows ample time for the application to process and permits the new owner to begin billing once the CHOW is complete.
- The new owner’s enrollment application may be submitted even while the previous owner is still practicing/billing.
- AFTER the transfer of any outstanding prior approval requests and all the previous owner’s claims have been filed and paid, the previous owner must terminate their NPI via a Manage Change Request (MCR). In the MCR, the previous owner must end date all active health plans (the end date should be the CHOW transaction date), and select “Provider Terminated due to change of ownership” as the reason for ending coverage.
- The seller is encouraged to submit the MCR 30 days prior to the CHOW transaction date. The MCR will not allow the health plans to be end dated with a retroactive date. The seller can only enter a current or future date when terminating health plans.
Note: If the previous owner is unable to terminate the record, the new owner can request to have the record terminated by submitting a written request and one of the following documents as proof of the CHOW:
- Bill of sale
- Stock transfer agreement
- Letter relinquishing ownership from old owner
- Executed lease purchasing agreement
Supporting documentation can be submitted to NCTracks via:
Fax #: 855.710.1965
E-mail: NCTracksprovider@nctracks.com
Mailing Address: CSRA, PO Box 300009, Raleigh, NC 27622-8009
For information regarding the Prior Approval (PA) update process for CHOW, please see the announcement Automation of Prior Approval Update with Change of Ownership.