“NCTracks is a nightmare”, “NCTracks, example of how government poorly runs a business”, “Because of the new system, it is doubtful that we will receive any Medicaid reimbursements for the clients we serve ”, “With no end in sight to the problems” … These are some of the headlines you will see if you Google NCTracks news. Sounds like a disaster, isn’t it?
A legacy system in use for 35 years is changing. Change is not easy and so is change with NCTRACKS. But it is a change for the good, it is a change to have modern processes, it is a change to eliminate many paper processes, and it is a change to be more electronic.
NCTracks is designed to process more than $12 Billion claims each year for 1.5 Million patients and more than 70,000 providers, including Local Public Health Departments.
Local Health Departments provide low barrier to care for communicable diseases, women and children to keep the general public healthy. At Health Departments, patients are enrolled in programs such as Sexually Transmitted Diseases, Maternal Health, Immunizations etc.
In the old, NC Medicaid HP claims processing system Health Departments filed claims based on programs. The old system used a 7 digit “atypical” number (ATN) to identity the program the patient was seen in. ATN is an outdated concept, not used elsewhere.
Commercial payers and Medicare use the 10 digit attending provider’s NPI and Taxonomy code to identify type of provider (pediatrician, OBGYN, etc.) and hence the program.
What does that mean, many health departments were maintaining at least 2 separate claims filing systems:
1. One system supporting the atypical number (ATN) for old NC Medicaid HP System.
2. Another system supporting Attending Provider NPI and Taxonomy Code for commercial payers and Medicare.
Health Departments who could not afford the overhead of 2 systems either did not accept commercial payers or Medicare or filed these claims on paper by handwriting the information on the CMS 1500 form. Health department staff spend weeks during flu season handwriting the hundreds of claims from a mass immunization drive done in our neighborhoods and work places.
This has changed with NCTracks.
Just like commercial payers and Medicare, NCTracks now uses the Attending Provider’s NPI and Taxonomy Code and the Health Department Taxonomy Code to identify the program to pay the Health Departments their enhanced reimbursement rates. Local health departments have seen these changes on their paid claims they have received from NCTracks.
Now health departments can have 1 claims filing system to file claims “electronically” to NCTracks, commercial payers and Medicare.
Isn’t this a good change to eliminate paper based claims, have more modern processes and be more electronic!