Work History Gap Explanation Required With Initial and Re-enrollment Applications

As part of the previously announced upcoming change to the NCTracks system regarding new information required on individual provider applications, providers will be required to submit a written explanation for any gap of six months or more in work history.

When a provider enters their work history on an Initial or Re-enrollment Application and 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 Individual Provider Agreement and the work history gap explanation, faxed, digital, electronic, scanned or photocopied signatures are acceptable, but signature stamps are NOT permitted.

For more information on the new requirements, please see the chart in the announcement Details on New Information Required on Applications for Individual Providers.

M20203-R-2303-9