Prior Approval - Electronic Submittals Encouraged

Providers who submit Prior Approval (PA) requests online through the NCTracks can save time and effort by not submitting paper forms.

CSC, the new DHHS fiscal agent, will make determinations on most types of PA requests, including FL-2 requests for long-term care placement. Requests sent to CSC via NCTracks do not have to be re-keyed into the system at the receiving end, as a paper form would. The electronic format also allows providers to attach documentation as PDF files, instead of mailing them. NCTracks also allows providers to monitor the status of PA requests, including those not submitted to CSC.

The NCTracks Prior Approval Tool Kit contains additional information about how PA works in NCTracks.

Providers who continue to submit paper PA requests should make sure they are using CSC forms and not those from legacy systems. Appropriate forms are available on www.nctracks.nc.com (pharmacy), or on the Division of Medical Assistance website: http://www.ncdhhs.gov/dma/provider/forms.htm (medical). Note that the forms from legacy systems do not include taxonomy codes.