License and Accreditation FAQs

A “How to Add or Update Accreditation on the Provider Profile in NCTracks” User Guide is posted that provides step-by-step instructions for adding or updating a license, certification, or accreditation on a provider record.  It can be found on the Provider User Guides & Fact Sheets page of the NCTracks Provider Portal under the heading "Provider Record Maintenance."

 

It takes approximately 10 business days to process the MCR.  Providers must be sure to submit the MCR to update their credential in time for processing prior to expiration. If there is a pending MCR when the notification is received that did not include updated credential information, the provider has the option and is encouraged to withdraw the pending MCR and resubmit with the license/accreditation/certification renewal information to ensure the update is processed prior to suspension/termination date.

 

If the taxonomy is suspended, submission of an MCR will not lift the suspension. The MCR must completely process before the suspension would be lifted the following day.

After initial enrollment, providers do not need to update this information. NCTracks receives a weekly data file sourced from the DEA to automatically update the expiration dates for the DEA certifications in provider records. If you have renewed your certification with DEA and your DEA number is correct in NCTracks, you can retain the certification letter and associated documents for your records.

 

NOTE: Clinical Laboratory Improvement Amendments (CLIA) is another certification that is updated automatically, but it occurs biweekly.

NCTracks sends a 60, 45, 14, 7, and 2day notification informing a provider of an expiring required credential.  If a provider fails to update their required credentials (licenses, certifications and accreditations) prior to the expiration date on file, the associated taxonomy will be suspended. These notices are sent to the Provider Message Center Inbox in advance of the expiration date of the credential.  

 

If the provider fails to update their required credentials within the allotted time, two additional notifications are sent informing the provider they are suspended with instructions for how to proceed. The taxonomy code that requires the expired credential will terminate on the 61st calendar day following suspension.

 

• If the terminated taxonomy represents the only taxonomy for that service location or provider record, then the service location or provider record will also terminate.
• If the provider record terminates, reenrollment is required to participate in the Medicaid programs.  Payment is not allowed through NCTracks or any other vendor until a provider is actively enrolled with NC Medicaid.

The taxonomy code that requires the expired credential will be suspended. A suspension letter will be generated and sent to the Message Center Inbox with the subject Recertify Suspension Letter. The suspension will remain in place for another 60 calendar days unless the credential is renewed and reported, in which case the suspension will be lifted.  

 

Note: Suspension means your claims will pend and will not pay until the suspension is lifted. 

The taxonomy code  that requires the expiring credential will be terminated on the 61st calendar day following suspension. If the terminated taxonomy represents the only taxonomy for that location or provider record, then the service location or enrollment record will also terminate. If you are terminated, you must reapply to participate in North Carolina Medicaid  program and will not receive payment through NCTracks or our other vendors. 

Specific qualifications for each provider taxonomy are listed in the Provider Permission Matrix (PPM). The PPM and instructions for how to use it are posted under Quick Links on the Provider Enrollment page of the NCTracks provider portal.

The license number should be keyed with dashes exactly as it appears with your license authority.

NCTracks receives some provider license information directly from the licensing authority, such as the NC Medical Board. When you key your license into NCTracks, it will be validated against the information received from the licensing authority. However, if you have only recently obtained your license, NCTracks may not have received the information yet. If you receive an error message regarding your license, contact the CSRA Call Center at 1-800-688-6696.

NCTracks receives credentialing information from some licensing boards, DEA, and CLIA. When the credential is updated in time to be received on the file, NCTracks automatically updates the expiration dates in the provider record, and the provider does not need to submit a Manage Change Request (MCR) to update the credential.

 

However, it is the provider’s responsibility to ensure their credentials are updated on their NCTracks provider enrollment record prior to expiration. If you receive a letter that you need to update your credential, make sure it is updated with the credentialing authority and that NCTracks has the new expiration date on file.

 

Occasionally, there is time gap between NCTracks’ of updated credentials and the expiration date, causing suspension.  If in receipt of the updated credential, providers may enter the new expiration date to prevent suspension or termination due to expired credentials. This updated credential will still be validated, but will prevent suspension for expired credentials if the  file is not received in the appropriate timeline for license expiration.  For more information on this update, please see the Medicaid Bulletin Changes to Provider Verification Process in NCTracks Begin May 9, 2021.

 

Note: Only North Carolina license information can be updated through a file. Border/Out of State providers must complete the MCR to ensure their record is up to date before expiration.

The plus sign indicates that section has been collapsed to make the webpage easier to read. To see more information, expand the section by clicking on the plus sign. Taxonomy codes are one example of sections with a plus sign. Providers should review all information under plus sign entries to ensure that their information is accurate.

On the accreditation page of the application just above the license requirements there is a paragraph that lists the accreditations, certifications, and/or licenses you must provide, based on provider type. This will also assist in determining if you need to end date a taxonomy code. When you have taxonomies that require licenses you do not have, you must end date the taxonomy that is causing the licensing/accreditation requirement. To do this, select the plus sign next to the taxonomy you need to end date.

 

Select ‘edit’, then select ‘end date.’ You can choose an end date in the future, or it will default to the current date. Then select ‘update.’  End-dating the taxonomy code will also end-dates the accreditation requirement. It’s important to make sure you still have at least one valid taxonomy code for each services location on the provider record.

Refer to the User Guide “How to Add or Update Licensing and Accreditation on the Provider Profile in NCTracks” under the heading Provider Record Maintenance on the Provider User Guides & Fact Sheets page of the NCTracks provider portal.

Providers with questions may contact the CSRA Call Center at 800-688-6696 or NCTracksprovider@nctracks.com.