A Message from NCTracks on Behalf of N.C. Medicaid DHB Will No Longer Review Behavioral Health Claim Denials for EOB 06702

Behavioral health claims denied for EOB 06702 can be resubmitted with medical records (including the admit and discharge summary) for review by medical staff at GDIT for FINAL determination. The claims will no longer be reviewed by the State for an override. Please follow the guidance provided in the EOB message:

EOB 06702 SERVICES DENIED. THE SERVICE OR SERVICE/PRIMARY DIAGNOSIS COMBINATION IS COVERED BY BEHAVIORAL HEALTH (BH) AND CLAIM SHOULD BE RESUBMITTED TO APPROPRIATE BH PLAN. IF BH WAS NOT THE REASON FOR THE VISIT, THEN CHECK YOUR PRIMARY DIAGNOSIS, CORRECT AND RESUBMIT YOUR CLAIM. IF NO CLAIM UPDATES ARE NEEDED, RESUBMIT CLAIM TO NCTRACKS WITH APPROPRIATE MEDICAL RECORD DOCUMENTATION FOR REVIEW.