Provider Re-credentialing/Re-verification

This section is intended to help NC DHHS providers understand the online Re-credentialing/Re-verification process in NCTracks. Additionally, providers will find links to Provider Announcements, User Guides, and Frequently Asked Questions.

What is this about?

The Affordable Care Act mandates that all Medicaid Providers must be revalidated every 5 years. This is to ensure that provider information is accurate and current. As part of this process, the provider’s credentials and qualifications will be evaluated to ensure they meet the professional requirements and are in good standing. The re-credentialing process also includes a criminal background check on all owners and managing relationships associated with this provider record.

Is it Re-credentialing or Re-verification?

The terms re-credentialing and re-verification are used interchangeably in NCTracks.  Either is acceptable.

How will I know if I need to complete the Re-credentialing application?

 

You will receive a re-credentialing/re-verification invitation via their NCTracks secure portal, when you are scheduled to begin the re-credentialing process.

 

Note: Providers cannot access the re-credentialing application until they receive an invitation to begin the process.

Is there a fee required?

A $100 NC Application Fee is required from individual providers and $100 NC Application Fee is also required per tax ID from organizations and atypical organizations if active in Medicaid and/or NCHC.

 

How Much Time do I have to complete the Re-credentialing process?

You will be given 45 days to complete the application. If the application is not completed within that time frame, your record will be suspended and claims will not be paid. You will receive a suspension letter via regular mail to the correspondence address on record as well as via NCtracks message center. Once the record is suspended, the due date to complete the re-verification will be extended 30 additional days. To continue participation in the North Carolina DHHS program you must complete the re-credentialing by that date or you record will be terminated.

Note: The termination date will be printed on the suspension letter.

What happens if I don’t complete the Re-credentialing application?

Your enrollment will be terminated, and you will be required to submit a re-enrollment application if you wish to continue to render services with NC – Medicaid.

 

Provider Re-credentialing/Re-verification Announcements

All Announcements