The Latest On Monday’s Changeover To NCTracks

The new DHHS claims system, NCTracks, will phase into operations as it goes live July 1. Health care providers are unlikely to notice except when accessing the new claims-status feature.

DHHS and its partner, Computer Sciences Corp. (CSC), will work around the clock the first two weeks of July to make sure any problems are quickly corrected. The NCTracks project team will also make sure the new system can handle the claims load before bringing it up to full speed. Besides normal claim volumes-an average of 1.2 million each week-NCTracks will have a backlog of 1.5 million claims that accumulated during the 10-day transition from old to new systems. While the backlog is being processed, adjudication times for batch claims will be extended. This ramp-up is similar to what happened when Medicare replaced its system. Complex systems start slowly and build speed as issues are identified and addressed.

The impact to providers will be largely invisible, except the new claims-status indicator will not be immediately available to all. Providers who submit claims through the online portal (www.nctracks.nc.gov) will know almost immediately after submittal whether the claim will pay, or what errors are causing it to deny. Providers who either submit batch claims themselves, or employ a billing agent or other trading partner, will receive a 999 notification that the claim has been accepted, but will be unable to obtain detailed claim status information during the startup period.

The effect on payments should be neutral. Most providers will not receive a payment until after the second week of operations, as indicated in the NCTracks checkwrite schedule, with electronic payments issued July 17. DHHS will pay pharmacy point-of-sale providers, whose claims must adjudicate in real time, after the first week, issuing payments July 10.

NCTracks replaces aging claims systems that process 88 million claims annually, totaling $12 billion, filed by 74,000 health care providers who treat more than 1.7 million beneficiaries of N.C. Medicaid and state-paid mental health, public health and rural health programs.

 
 

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