Re-credentialing necessary for continued participation in Medicaid/CHIP

Thousands of Medicaid providers received re-credentialing notices from NCTracks yesterday, which invite recipients to submit completed applications within 45 days. The notices were sent by CSC via regular mail and electronically to each provider’s Message Center Inbox on the NCTracks Provider Portal.

Please look for this notice today, and if you receive one, act promptly to begin the process. Providers that do not submit completed applications by the deadline will see Medicaid claims and payments suspended, and could also eventually have their participation terminated.

Since 2013 the automated function of notifying providers that it was time to complete re-credentialing has been disabled in NCTracks. This was due to technical glitches, inaccurate Medicaid provider records, legislative changes, and other reasons. Yesterday’s batch of notices is the first since the functionality was restored and activated, and NCTracks will continue to notify providers in this manner as they approach the end of their five-year cycles.

Federal Medicaid regulations and state law require providers to undergo re-credentialing periodically.  Thanks to lobbying efforts by the North Carolina Medical Society earlier this year, the provider re-credentialing cycle was extended from every three years to every five years. This positive change will reduce your costs and the administrative burdens associated with Medicaid participation.

The Division of Medical Assistance and CSC have published several articles with additional details, including the following:

DMA Provider Bulletin, page 2 – NCTracks Re-credentialing Notices, Oct 2015

NCTracks Announcement – Reminder of NCTracks Re-Credentialing Process, 10/28/2015

NCTracks – General Information and FAQ on Re-credentialing

NCTracks Job Aid – How to Determine Re-credentialing Due Date