Time Limit Override Updates Coming to NCTracks

Time limit Override updates

Beginning Oct. 8, 2023, NCTracks will be providing state approved time limit override for claims processing information on the X12 271 Eligibility Response and the Provider Eligibility Response on the provider portal, when applicable.

Up to three of the most recent active time limit override information spans will be returned. If there are more than three time limit override information spans, providers will be instructed to contact the NC Medicaid Contact Center at 888-245-0179 to receive additional information. If the Recipient does not have any active time limit override information spans, no information will be returned.

Recipient eligibility dates may not be consecutive

The recipient’s eligibility dates may not be consecutive if the approved time limit override has a range of dates that is more than two dates of service. Providers will not be able to check the recipient’s eligibility via the provider portal or X12 270/271 Eligibility Request/Response if the date of service is greater than 365 days. Please verify the recipient’s eligibility during that period with the NC Medicaid Contact Center at 888-245-0179.

Example: Time limit override was approved for dates of service 01/01/2022 – 06/30/2022 and the time limit override file by date is 11/30/2023. The Recipient may only have eligibility on 01/05/2022, 01/08/2022, 01/15/2022, etc.

X12 271 eligibility response

The time limit override will be reported on the first eligibility span only in the 2110C MSG segment of the X12 271 eligibility response. The information will be identified by “TLO” in the first three bytes of the segment, followed by up to three time limit override information spans. The information will include the dates of service, identified by “DOS” and the “from and to” dates of service, separated by a dash (“-“), and the “file by” date. Each span will be separated by a comma. If there are more than three time limit override information spans, the segment will include a message to contact the NC Medicaid Contact Center.  

Examples of the X12 271 Eligibility Response 2110C MSG segment

More than three time limit override information spans

MSG*TLO DOS 04/28/2022-04/28/2022 FILE BY 11/30/2023,DOS 04/25/2022-04/26/2022 FILE BY 11/30/2023,DOS 03/01/2022-03/01/2022 FILE BY 11/30/2023,CONTACT THE NC MEDICAID CONTACT CENTER AT 888-245-0179 FOR ADDL TLO~

Only three time limit override information spans

MSG*TLO DOS 04/28/2022-04/28/2022 FILE BY 11/30/2023,DOS 04/25/2022-04/26/2022 FILE BY 11/30/2023,DOS 03/01/2022-03/01/2022 FILE BY 11/30/2023~

Less than three time limit override information spans

MSG*TLO DOS 04/28/2022-04/28/2022 FILE BY 11/30/2023,DOS 04/25/2022-04/26/2022 FILE BY 11/30/2023~

An updated version of the X12 270/271 Companion Guide can be found on the NCTracks public provider portal Trading Partner Information webpage.

Recipient Eligibility Response on the Provider Portal

A new section, called “Time Limit Override,” will be added to the bottom of the Provider Eligibility Response page on the Provider Portal. Up to three time limit override spans will be returned, and the information returned will include the “From Dates of Service,” “To Dates of Service,” and “Date By Which Claims Must Be Filed.” If there are more than three time limit override information spans, the segment will include a message to contact the NC Medicaid Contact Center.