An Update from NCTracks on Behalf of NC Medicaid SPECIAL BULLETIN COVID-19 #140: Portal Live – Reimbursement for COVID-19-Related Primary Care Services for Uninsured Individuals Living in NC

This is an update from NCTracks on behalf of NC Medicaid; the following bulletin is being shared from the NC Medicaid website.

Last month a program to reimburse primary care providers (PCP) for providing COVID-19 related primary care services (e.g. follow-up care) to uninsured individuals living in North Carolina was announced. The portal for providers to submit the request for reimbursement is live and can be accessed through the NCTracks secure portal.

Key Program Facts

  • $7.8M is available to support the program on a first-come, first-served basis until exhausted or until Dec. 30, 2020, whichever comes first
  • A payment of $150 per eligible in-person or telehealth visit enables providers to recoup costs for COVID-19 related services provided for uninsured patients

Eligibility

Individuals are eligible for the program if they live in North Carolina and have no health care coverage (e.g. Medicaid, Medicare, or other health insurance). Eligible providers are PCPs that operate in the state of North Carolina and are registered in NCTracks, North Carolina’s Medicaid payment platform.

NCTracks Attestation Form includes the following language:

By submitting this transaction to the NC Department of Health and Human Services, I attest that the service performed is accurately represented as shown, and the patient was uninsured, and the service was a COVID-19 related primary care service. I further attest that claims have been either submitted to the HRSA portal and denied or were not submitted because they were ineligible for HRSA reimbursement. I understand this transaction is a request for payment from CARES Act funding and is subject to audit by the Office of the State Auditor and other oversight organizations.

Action Items for Providers

  1. Confirm enrollment as a provider in NCTracks;If the provider is not enrolled, they should complete enrollment through the NCTracks portal
  2. Submit all qualifying claims from Sept. 1, 2020 to present
  3. Continue providing COVID-19 related care to patients
  4. Continue submitting all qualifying claims as frequently as funding is available on a first-come, first-served basis until exhausted or by Dec. 30, 2020, whichever comes first

Portal Training

  • PCPs can attend a training to better understand how to submit qualifying claims through NCTracks; training dates are Nov. 9, 10, 12, 17, 18 and 20. Click here for more information and to register for a training session.
  • Job aids will be available on NCTracks to review in advance of the training sessions; PCPs should not wait until the training to submit claims.

Finance Updates

Funding is first-come, first-served until exhausted or until Dec. 30, 2020, whichever comes first. PCPs will be reimbursed in subsequent NCTracks checkwrites issued by the Division of Health Benefits. PCPs should check the COVID-19 Related Services for Uninsured Individuals webpage for finance updates. Remaining funds will be updated on the website weekly.

Other Provider Benefits

There are multiple programs available to support providers who are responding to the COVID-19 pandemic. A fact sheet and chart listing other supports available are on the DHHS COVID-19 Response - Providers, Hospitals and Labs webpage under Resources to Support NC Providers Responding to COVID-19.

For more information, please visit the COVID-19 Related Services for Uninsured Individuals webpage.