NCTracks Hepful Information- Avoid Common Errors in Required Enrollment Documents

We are seeing an increase in provider applications being returned due to incomplete uploaded documentation. Please ensure the uploaded documents meet the requirements to avoid further delays. 

  • If you are notified to provide an explanation for a work history gap, please ensure the explanation is signed by the provider and dated within the past 6 months.
  • If you are required to upload an explanation of an exclusion/sanction question response, please ensure the explanation is signed by the individual attached to the exclusion/sanction or the Office Administrator AND is dated within the past 6 month.
  • If you are required to complete a DEA Designation Form, please ensure the form is signed by the provider, includes the reference ID, includes the provider’s printed name, and is dated.
  • If you are required to complete a NC Medicaid Non-Emergency Medical Transportation (NEMT) Provider/Broker Attestation Form, please ensure the form is signed by the Office Administrator, includes the printed name of the OA, and is dated within the past 6 months.
  • If you are required to complete a NC Medicaid Community Behavioral Health Taxonomy 251S00000X Provider Attestation Form, please ensure the form includes the provider name, NPI, and Reference ID of the application AND is signed by the Office Administrator, includes the printed name of the OA, and is dated within the past 6 months.
  • If you are required to complete a NC Medicaid Speech Language Pathologist Taxonomy 235Z00000X Provider Attestation Form, please ensure the form includes the provider name, NPI, and Reference ID of the application AND is signed by the provider, includes the printed name of the provider, and is dated within the past 6 months.