Medicaid Recredentialing–What’s New?

Recredentialing of Medicaid providers is now a paperless process. Recredentialing physicians will complete the process online, using instructions that are being mailed to providers by Computer Sciences Corporation (CSC), the Medicaid vendor responsible for enrollment and credentialing in North Carolina. Once online, physicians will find their application automatically populated with the information currently on file with CSC. According to Medicaid, most physicians and other providers will need only to validate what’s on file or revise information that has changed or is incorrect.

NC Medicaid recently tested the new all-electronic system with 100 Medicaid providers. Only minor problems were reported, allowing the state to expand the online program to all 72,000 Medicaid providers in North Carolina this month. In order to transition recredentialing to an all-electronic process, CSC is mailing providers a letter that contains a personal Recredential ID, information about a North Carolina Identification Number (NCID) needed for online processing, and detailed instructions for accessing the online application. The federally mandated recredentialing process includes a check of criminal background, credentials, and qualifications to ensure providers meet NC Medicaid guidelines for participation.

Providers have 30 days to provide the information required and must pay a $100 fee at the time of recredentialing. If you have difficulty in meeting the deadline or need assistance, NC Medicaid urges you to contact the Enrollment, Verification and Credentialing (EVC) Center at 1-866-844-1113 or email NCMedicaid@csc.com.

More information about the recredentialing process will be published in the December issue of the Medicaid Bulletin, which can be accessed starting November 30, 2011, at http://www.ncdhhs.gov/dma/provenroll/index.htm.

 
 

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1 Comment

  • I was just credentialed within 2011, this current year. My credentialing process was determined complete by ncmedicaid@csc.com email to me on May 18, 2011. I saw my first Medicaid patient on June 27, 2011.

    I object to this redundancy of time, money, and effort within 5-6 months. What is the appeals process? Charlotte A. Sweeney MD FACOG