Point of Sale Claims and Reversals

Pharmacy point-of-sale claims are submitted as real time claims. Claims over $9,999 require manual review for validity. Please note that NCTracks Pharmacy Call Center is not able to perform pharmacy claim reversals for any point-of-sale claims that are submitted – including test claims and claims submitted for over $9,999 that require manual review. Additionally, claims over $9,999 cannot be reversed until manual review has occurred.  Pharmacy claim reversals can be performed by the pharmacy that submits the claim via the NCtracks Provider Portal. Instructions for claim reversal can be found on the NCTracks Pharmacy Services page under Quick Links titled “How to Enter a Pharmacy Claim Reversal on the Provider Portal”.