Disaster Relief Enrollment Application Streamlined

Effective July 28, 2019, an expedited Disaster Relief Provider Enrollment Application process will be available during times of disaster such as a State of Emergency. This abbreviated enrollment application will collect limited information to enroll a provider for a limited time (120 days) and will be available to in-state, out-of-state (OOS) and border providers that are not yet enrolled in NC Medicaid, including individual providers and organizations.

For the Disaster Relief Provider Enrollment Application only, federal application requirements may be waived (training, site visit, federal/state fees, background checks, and fingerprinting).

The enrollment application process will be expedited. NCTracks will verify the provider’s enrollment status with Medicare or the provider’s home State Medicaid agency to ensure the provider is in good standing. NCTracks will deny the Disaster Relief Provider Enrollment Application if the provider is not in good standing.

More information will be provided during a disaster which deems the Disaster Relief Provider Enrollment Application necessary for relief efforts.