NCTracks
EHDI Added to Benefit Plans for Prior Approval Requests
The Early Hearing, Detection and Intervention (EHDI) Program at the N.C. Division of Public Health (formerly known as POMCS) is one of the participating services in the NCTracks system. The EHDI program provides services for eligible children from birth to 3 years of age with hearing loss. Since NCTracks go-live, the EHDI program has been missing from the Benefit Plan drop down box on the Prior Approval tab of the secure Provider Portal. As a work around for the missing EHDI drop down option, the EHDI program staff has been entering the required information in the system for their providers during this time.
This issue has been fixed and now providers are instructed to complete their Prior Approval Requests before rendering services to children eligible for the EHDI program.
Additional information regarding the EHDI option for PA requests:
- A Prior Approval (PA) request is located in the secure Provider Portal under the Prior Approval tab. For EHDI services, select Public Health (as payer) and then select EHDI as the (benefit plan) in the NCTracks system. PA Requests reminders: be sure that the requested dates of service are within the eligibility dates in NCTracks, no dollar amounts are needed when entering your billing codes (leave that blank)
- The program will pay the cost of the specific covered services if the recipient does not have Medicaid or any other form of insurance. The amount paid will not exceed the Medicaid rates. There is one exception to EHDI paying for a service when the recipient has insurance. This exception is when the recipient’s insurance company denied the claim or applies the claim to the deductible or co-pay. In these cases, EHDI will pay for the covered services up to Medicaid rates.
- EHDI covered services for children ages 0 to 3 include: the initial first time hearing aid dispensing & fitting fees, ear molds, batteries and the accessory kit.
- The Prior Approval Request should be completed in its entirety. Once completed, the EHDI managers at the Division of Public Health will review and approve/deny the PA request based on the program’s eligibility requirements.
- Computer Based Training (CBT) is available regarding Prior Approval and NCTracks. Providers can register for CBT courses in Skill Port, the NCTracks Learning Management System. Logon to the secure NCTracks Provider Portal and click Provider Training to access Skill Port. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The courses can be found in the sub-folders under CBTs, based on the topic of the course. Refer to the Provider Training page of the public Provider Portal for specific instructions on how to use Skill Port. The Provider Training page also includes a quick reference regarding Java, which is required for the use of SkillPort. Additional information can be found on the Prior Approval page of the NCTracks Provider Portal.