The NC Department of Health and Human Services (DHHS) and CSC, the firm overseeing the implementation of the new Medicaid claims system, are working 24/7 to make the transition as smooth as possible and have already fixed some of the initial problems practices were facing during the first week of the transistion.  Be sure to continue to log any problems you experience on the North Carolina Medical Society’s Trouble Log to help us track the issues and work with CSC to correct them. Here is the latest from CSC on other issues to be aware of before the first full checkwrite on July 17.

1. Taxonomy Errors – The most common error in batch claims submitted to NCTracks, either by individual providers or a trading partner, is missing or wrong taxonomy codes. 

It is important that providers use the appropriate taxonomy code from their NCTracks provider record based on the service rendered and the rendering/attending provider location when submitting claims to the NCTracks system to facilitate timely adjudication. Also, verify that the billing provider taxonomy code on the claim matches one of the taxonomy codes listed on the NCTracks billing provider record and is appropirate for the claim being billed.

Both the group/billing provider and the rendering provider have their own taxonomy codes, which should be reflected on the claim. (The only exception to this is for DMH claims. DMH claims can have a group taxonomy code assigned to the rendering provider.)

Please note that when you submit batch/X12 claims electronically (not via the web portal) you will need to use the service facility field to indicate the rendering/attending provider location. Taxonomy codes are required on all claim types except pharmacy. Providers can verify their taxonomy code using the Provider Taxonomy Lookup webpage.

2. Transmitter Supplier Number (TSN) Errors – Many of the claims submitted through a trading partner (billing agent, clearinghouse) to date have Transmitter Supplier Number (TSN) errors. If your trading partner received a 999 rejection when submitting claims you will need to verify:

• You have the correct TSN on the claim.
• The submitter/trading partner is currently enrolled.
• The submitter/trading partner is currently certified.
• The submitter/trading partner is linked to your provider record/NPI.

If you have questions about which TSN to use or the submitter/trading partner status, please contact your submitter/trading partner to verify information.

 3. Ensure Payments by Completing the EFT Process
 Providers who have not completed the electronic funds transfer (EFT) process should do so as soon as possible to avoid delays in payments. NCTracks cannot pay claims unless the EFT information is correct and the process completed.

As part of the enrollment process in NCTracks, providers are required to submit a bank account and bank routing numbers for EFTs. After completing the process, the system will then send a pre-note transaction to the provider’s bank to validate the information. For providers who have already completed enrollment and given account information, no further action is necessary unless a problem occurs in the validation, in which case a NCTracks system administrator will notify the provider.

Claims for a provider with a failed pre-note will suspend for 45 days. If the bank account information is not corrected during that time period, the claims will be denied. 

Remember that you can help avoid long waits on hold by checking the status of the system on the NCTracks Status page in the public Provider Portal. This page also includes announcements and a list of frequently asked questions (FAQ) and answers, both of which are being updated regularly based on the latest system information, including common errors found in claim submission.

Taking advantage of training opportunities and reviewing the frequently asked questions prior to submitting claims can assist in avoiding claim denials and potential delays in payment.

In an effort to assist providers, online training modules are available 24/7 for providers to learn how to use the new system at their own pace. Additionally, DHHS and CSC have scheduled a series of interactive information sessions over the next few weeks and regional training sessions beginning July 16. Provider Representatives will lead each session to walk providers through the key features of the new NCTracks system and the steps they need to take to submit claims and get paid. Providers can find a complete schedule of training topics on the NCTracks portal. If you have questions about NCTracks, please contact the Call Center at 1-800-688-6696 or [email protected]. NCTracks Call Center hours are being extended to 6:00 p.m. this week, through Friday, July 12.