Reminder to Include Claim and Completed Form with Override Request

When submitting an override request, it is essential that providers include the claim for which an override is being requested, as well as a completed Medicaid Resolution Inquiry Form and documentation to support the request. A significant number of override requests have been received without the claim. These requests cannot be processed.

In addition, the Medicaid Resolution Inquiry Form must be complete. The forms are frequently received without any override reason indicated. Providers must indicate the reason for the override or it will delay the time to process and may not produce the desired results. Note that claim overrides are only done for the reasons listed on the form.

A User Guide entitled "How to Submit Claim Adjustment and Time Limit and Medicare Overrides" that provides step-by-step instructions for submitting override requests can be found under the heading "Claim Submission" on the Provider User Guide and Training Page of NCTracks Provider Portal. (See link below)

The Medicaid Resolution Inquiry Form can be found under the heading "Provider Forms" on the Provider Policies, Manuals, and Guidelines page of the Provider Portal. (See link below) The inquiry form states it must include the claim, RAs and all related documents.