ATTENTION: Providers Of Outpatient Specialized Therapies Resolution of Prior Approval Issue for Outpatient Specialized Therapies

On June 26, NCTracks began modifying the end date in prior approval (PA) requests for beneficiaries who have transitioned from Medicaid Direct to Managed Care. In eligible PA records for beneficiaries three years of age and older, the end date is modified to align with the end date of the beneficiary’s Medicaid Direct eligibility. For records with modified end date, a notification is issued to the billing provider via the NCTracks Message Center to inform the provider of the date change. 

As previously announced, NCTracks incorrectly modified prior approval records for beneficiaries who are two years of age as of the approved PA begin date. NCTracks has corrected all impacted PA records with end date and status returned to the original date and status.