Update: Upcoming Payer Conversion for CPIDs 1480 and 3564 North Carolina Medicaid
CollaborateMD Blog
The clearinghouse would like to inform providers of updates for the conversion of CPIDs 1480 and 3564 North Carolina Medicaid to NCTracks on July 1, 2013. The clearinghouse is currently working to obtain transition details and will send additional notifications as soon as they are available.

Providers must be aware of the following:

Enrollment Changes:
As of 5/31/2013, the clearinghouse will no longer enroll providers for electronic claims or remittance through the current processor in order to prepare for the conversion to NCTracks. We will provide additional notification when the enrollment forms are available on Collaboration Compass.

Providers already approved to submit transactions through the clearinghouse do not need to complete a new agreement but must register in NCTracks and select "RELAYHEALTH" from the Billing Agent drop down field. Providers have been sent a letter from North Carolina Department of Health and Human Services (DHHS) with instructions for registering in NCTracks. If you have not received your letter, call 866-844-1113.

New providers will need to complete a new agreement when the forms are available on Collaboration Compass. Providers will be sent a letter from DHHS with instructions for registering in NCTracks. When registering in NCTracks select "RELAYHEALTH" from the Billing Agent drop down field.

Providers must register in NCTracks by July 1, 2013 indicating "RELAYHEALTH" as their Billing Agent and select the appropriate transactions for electronic claims or remittance. Providers will only be allowed to select one Billing Agent for Claims and Remittance prior to 7/1/2013. After 7/1/2013, providers will be allowed to modify their Billing Agents by transaction. Letters will be sent to providers by the payer with instructions for updating Billing Agents at a later date.

It is important for providers to select "RELAYHEALTH" from the Billing Agent drop down field at the time of registration. If providers keyed "RELAYHEALTH" rather than selecting from the drop down field, please ensure the Billing Agent was keyed only as "RELAYHEALTH". If any variation of the name or a value other than "RELAYHEALTH" was keyed, your claims will not be linked to the clearinghouse, therefore causing claims to reject and/or delay in remittance delivery. Please review the Billing Agent selection and make necessary updates prior to 7/1/2013 to reflect the Billing Agent name only as "RELAYHEALTH".

Transition Schedule
-5/31/2013 Last day the clearinghouse will accept electronic claims and remittance enrollments for HPES/ECS
-6/12/2013 Last day HPES/ECS will accept paper claims
-6/20/2013 Last day HPES/ECS will accept electronic claims submissions as of 4:00pm CT
Claims must be submitted to the clearinghouse by 1:30pm CT on 6/20/2013 to meet the payers cutoff time
-6/27/2013 Last day HPES/ECS will produce electronic remittance
-7/1/2013 First day NCTracks will accept transactions as of 5:00am CT
-7/9/2013 approximate date first electronic remittance will be available

Dark Days
For electronic claims: from 6/20/2013 1:30pm CT through 7/1/2013 5:00am CT. The clearinghouse will hold claims during this time and will begin submitting claims after 5:00am CT on 7/1/2013.

For electronic remittance: from 6/27/2013 through approximately 7/9/2013.

Edit Changes
Billing Provider Taxonomy Code is required when NPI is present or claims will reject with edit PPRV0318EW for Professional claims and edit IPRV0313EW for Institutional claims. Providers may begin submitting Billing Provider Taxonomy Codes now to avoid rejections on or after 7/1/2013.

Rendering Provider Taxonomy Code or Attending Provider Taxonomy Code is required when the associated NPI or Atypical Provider ID is present or claims will reject. Providers may begin submitting Rendering or Attending Provider Taxonomy Codes now to avoid rejections on or after 7/1/2013.

The NCTracks system uses NPI, taxonomy codes, and location to process and pay claims. Providers are encouraged to verify their taxonomy codes and locations at http://ncmmis.ncdhhs.gov/taxonomy.asp before July 1. Claims submitted in NCTracks with codes that do not match your provider taxonomy will be denied.

Reports
The clearinghouse will no longer receive claim level information for Standardized Reporting on or after July 1, 2013. Claim updates will be returned either in an 835 Electronic Remittance File; or in an Explanation of Benefits (EOB) pdf file available through NCTracks provider portal.

Action Required: Providers must register in NCTracks by July 1, 2013 indicating "RELAYHEALTH" as their Billing Agent and select the appropriate transactions for electronic claims or remittance. Providers will only be allowed to select one Billing Agent for Claims and Remittance prior to 7/1/2013. After 7/1/2013, providers will be allowed to modify their Billing Agents by transaction. Letters will be sent to providers by the payer with instructions for updating Billing Agents at a later date.

If you have any questions, please contact Client Services at 1-888-348-8457, option 2.