NC TRACKS: Claims Pended for Incorrect Billing Location

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NC TRACKS: Claims Pended for Incorrect Billing Location


Urgent NCTracks Billing Notice

Claims Pended for Incorrect Billing Location

If your agency bills North Carolina Medicaid, please forward this email to the appropriate member of your billing staff and/or director/owner of your agency.

Effective October 29, 2017, the NC Department of Health and Human Services will implement in NCTracks the validation of the billing provider address submitted on the claim to the location listed on the provider record for the date(s) of service submitted. The billing provider address, city, state, and zip code (first 5 digits) on all NC Medicaid and NCHC claims must match EXACTLY with the corresponding information on the provider record.

If NCTracks cannot match the billing provider's address to an active service location in the NCTracks provider's file, the claim will be pended for 60 days to give the billing provider time to add the address. Providers should verify the address submitted on the claim is a valid and active address on the provider's record.  
 

URGENT: To Avoid Pended Claims, Compare Your Agency Information in Barnestorm to NCTracks Before October 29, 2017

Since this new requirement is effective starting October 29, we suggest that you proactively look in Barnestorm before then to make certain the following information matches what NCTracks has on file (for your agency):  Address, NPI and Taxonomy. Failure to do so may result in pended claims for your agency.

If there are any differences, here is how to change what's in Barnestorm:
  1. Pull up your provider information in NCTracks so you can compare it to Barnestorm.
  2. Log into Barnestorm Office.
  3. Go to Billing HIPAA Transactions > Edit HIPAA Payers.
  4. Pull up each payer (billed via NCTracks) to verify the NPI,  address, and Taxonomy. Compare it to NCTracks.
  5. Make any needed changes in Barnestorm. Note that even spacing, spelling and "ST" instead of "Street" will cause issues! If you're in doubt, copy the address in NC Tracks and paste it into Barnestorm so you can be sure it matches exactly.
  6. Press the Save button in Barnestorm HIPAA Payers.  
  7. Or contact NCTracks so they can help you update your information in their system if it's incorrect there. NCTracks Main Call Center: 1-800-688-6696
NOTE: Barnestorm does not have your NCTracks records and we are unable to access that information. Barnestorm cannot contact NC Tracks on your behalf or change anything in your agreement with NC Tracks, which is a confidential contract between the provider and the State of North Carolina. If you have any trouble finding your info in NCTracks, please contact NCTracks to verify it or to get guidance so that you can view it. Make sure that what's in Barnestorm HIPAA Payers matches what is in your NCTracks record for each payer and each NPI.

NCTracks Main Call Center: 1-800-688-6696 

If NCTracks cannot match the billing provider's address to an active service location in the NCTracks provider's file, the claim will be pended for 60 days to give the billing provider time to add the address. The pended claim will be displayed on the paper Remittance Advice (RA) with Explanation of Benefits (EOB) code 04529 - BILLING ADDRESS SUBMITTED ON THE CLAIM DOES NOT MATCH THE ADDRESS ON FILE.

Double check for spelling errors on the claim and/or NCTracks. This EOB indicates that the provider should add or correct the billing provider address in NCTracks or correct the address submitted on the claim. Claims pended with EOB 04529 will automatically recycle daily, so if the provider adds the correct address to the provider record, the claim will resume processing.

If the provider does not add the correct address to the provider record within 60 days, the system will deny the claim.The provider record can be updated with a new billing provider address by submitting an MCR in the secure NCTracks provider portal or correcting the billing provider's address on the claim to a service location on the billing provider's record. Note that the MCR may be subject to credentialing and verification. For guidance on submitting the MCR, refer to the User Guide "How to Change the Physical Address in NCTracks" in SkillPort.

Claims with dates of service prior to October 29, 2017, will not be subjected to the new business rules.

If you have any questions, please call NCTracks Main Call Center: 1-800-688-6696.  You can also view the information from the DMA Medicaid Bulletin (September 2017) by clicking DMA September 2017 Medicaid Bulletin.


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Last Modified:Thursday, October 19, 2017

Last Modified By: linda@barnestorm.com

Type: INFO

Rated 5 stars based on 1 vote

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