Re-verification Refresher

Last updated Jan. 11, 2022

Find a downloadable version of this information under Quicklinks on the Provider Enrollment Page or at the link to the right!

 

Federal law mandates that all Medicaid providers must be re-verified every five years to ensure that provider information is accurate and current. It has been over five years since the implementation of NCTracks, which means there are many providers who will need to complete re-verification. This announcement provides an overview of how the re-verification process works.

Notification

Providers will receive notification in the Message Center Inbox of the secure NCTracks provider portal when it is time for re-verification. The notification has the ID PM16000-R0053 with the description “Re-verification Letter.”

Timing

Providers have 70 days to submit their re-verification/re-credentialing application. Also, updates to owners’ and managing employees’ information (address, phone number, email) are incorporated into the re-verification application, instead of requiring a Manage Change Request (MCR).

Note: A re-verification application cannot be submitted for an NPI that has an MCR currently under review, and unlike the previous process, the due date of the re-verification will not be delayed/postponed.

Fees

Effective Jan. 9, 2022, NCTracks will no longer require Medicaid and NC Health Choice providers to pay the $100 NC application fee with enrollment and re-verification applications. This change is made pursuant to NC Senate Bill 105 Session Law 2021-180 Section 9D.9(a), which waives the fee until June 30, 2023. 

When applicable, providers maybe required to pay a federal fee. Fees by year may be found in the spreadsheet State and Federal Fee Amounts by Year located under Quick Links on the Provider Enrollment page. Fees must be paid when submitting the re-verification application. Refer to the Provider Permission Matrix on the NCTracks Provider Enrollment page to determine if the federal fee is required. For more information refer to the Federal Fee and NC Application Fee FAQ page.

Fingerprinting

Fingerprint-based background checks are required for all high categorical risk providers and owners who have a 5% or greater ownership interest. Refer to the Fingerprinting FAQ page for more information.

Consequences/Remedies

Failure to submit the re-verification application by the due date will result in suspension of the provider in NCTracks. If the re-verification application is not submitted within 50 days of suspension, the provider will be terminated from NCTracks.

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