Monday, July 1, is the long-anticipated and, perhaps, much-dreaded transition to the NC Tracks Medicaid claims filing system. The NC Department of Health and Human Services (DHHS) is saying to expect 60 to 90 days of glitches in the system, as the bugs are worked out of this massive project. To be sure your practice will be ready and able to file claims beginning Monday, they offer a “Provider Go-Live Checklist.”

To deal with the anticipated problems, DHHS and its contractor for the project, CSC, have beefed up staff levels and operation hours at their Call Center, which will have the same toll-free number as the previous system (800-688-6696). They do warn, however, to expect lengthy hold times, although the on-hold message will update callers with the anticipated time on hold. Anyone who calls DHHS staff directly for assistance will be referred back to the Call Center, they said.

To help our members, the North Carolina Medical Society (NCMS) will be launching a web page prior to Monday, where practices may enter the specific problem they are experiencing with NC Tracks. NCMS staff will monitor the types of trouble being reported on the site to spot trends and then report these directly to CSC staff. This will not replace the necessary call to CSC to address individual practice issues, but we hope that by aggregating the types of complaints we will speed up the process of resolving the problems. Watch the NCMS website and your email for the link to this webpage.

Despite DHHS’ assurances that the system tests have been exhaustive and successful, some large billing agents and clearinghouses have expressed concern that there are major flaws that have not been addressed and that payment to providers may be delayed.

In a recent letter, Brad Deen of DHHS’s Office of Public Affairs said they have reached out to billing agents and clearinghouses to make sure they apply for a Trading Partner Agreement so they will be able to file claims on behalf of their practices. According to Deen, the agencies that account for roughly 80 percent of claims have successfully filed the Trading Partner Agreement. Those primarily smaller agencies that have not yet completed the agreement, however, may see delays and their practices may experience cash flow issues. To see if your practice’s billing agent or clearinghouse has completed the necessary filings, DHHS is updating this list every Monday.

Even if all the paperwork is properly filed at every level, however, DHHS and practices throughout the state are bracing themselves for some rough track ahead.