North Carolina Medicaid Enrollment and Billing

 
   

Navigating the Enrollment Process

*NEW!* 6/20/2024 NC Medicaid Releases New Guidance Document for Pharmacist Provider Enrollment

To Enroll:

  1. Visit NCTracks website (www.nctracks.nc.gov). Click Providers tab at the top of the page.
  2. See gray menu located on the left side of the page. Select: Getting Started with NCTracks.
  3. From the Getting Started with NCTracks page:
    1. If you do not already have a valid NCID or Password with NCTracks, go to https://myncid.nc.gov/ and click on Register.
    2. Once NCID and Password are established, return to Providers tab at the top of the page.
  4. Select Provider Enrollment from the gray menu option located on the left side of the page.
  5. Scroll to the bottom of the page: In the left column, Click image entitled Begin Application Start your own Provider Enrollment Application. 
  6. Enter User ID (NCID) and Password.
  7. Select Login.

Already Enrolled?:
For pharmacists already enrolled with NC Medicaid as a Clinical Pharmacist Practitioner (CPP) you can simply add the new taxonomy to your existing provider record by submitting a Manage Change Request (MCR).

  1. Visit NCTracks website (www.nctracks.nc.gov). Click Providers tab at the top of the page.
  2. In the top right column of the Providers page, Click the image entitled NCTracks Secure Portal Access the secure NCTracks Portal. 
  3. Enter User ID (NCID) and Password. Select Login.
  4. From the Provider Portal Home page, Select Status and Management. 
  5. Select the radio button to the record in which you want to begin an MCR application, Select Update.
  6. Under Requested Manage Change Request Type: Select the Manage Change Request radio button. 
  7. At Basic Information Page, scroll to the bottom and click: Next
  8. At Terms and Condition Page, select attestation checkbox and Next 
  9. Continue to select Next until you reach the Taxonomy Classification page.
  10. Follow Instruction marked with a RED Asterisk* in the section entitled Avoiding the Application “HARD STOPS” to add taxonomy 183500000X to your existing provider record.

Avoiding the Application 'Hard Stops':
Some questions in the application can lead to 'hard stops' in the process if answered incorrectly, preventing pharmacists from moving forward. See the table below for specific sections with answers to avoid these issues.

Application Heading

Subheading/Question

Answer

Helpful Hint
Online Provider Enrollment Application Provider Enrollment Application Type Select Radio Button - Ordering, Prescribing, referring Providers Enrolled with the Lite Application  
Individual Basic Information Identifying Information Last Name, First Name   Ensure your legal name matches the one associated with your National Provider Identification (NPI) record to avoid delays in the application approval process. To update your NPI profile, visit NPPES at https://nppes.cms.hhs.gov/#/
Individual Basic Information Identifying Information Email   Enter the email address you feel is most accurate for receiving Medicaid-related correspondence
Individual Basic Information Employer Identification Number (EIN)Will your income be reported to an EIN? Select: NO  
Individual Basic Information Ownership Information Business Type Select: Self (Individual Filling Under and SSN)  
Individual Basic Information Office Administrator (Authorized Individual) Select check box: Authorized Individual is the same as enrolling provider  
Individual Basic Information Effective Date Requested Effective Date:____   Pharmacists can choose to use the current date or backdate to the pharmacist's enrollment approval date of 1/9/2024
Addresses Primary Physical Location Enter the office phone number, office fax number, address, city, and state of the pharmacy where you mainly work. Click "Verify Address" (Ensure it matches a valid U.S. Postal Service address) The most likely location where the pharmacist enrollee will provide services
Addresses Servicing Counties Select the county corresponding to the pharmacy address you entered in the Primary Physical Location section of the enrollment application The most likely location where the pharmacist enrollee will provide services
Addresses 1099 Reporting/Pay-To Address Do you have a separate Pay-To address? Select: NO Pharmacists' enrollees will NOT receive a 1099 from Medicaid, and individual pharmacists will NOT directly receive payment from Medicaid for Pharmacy Services they provide. Although the pharmacist's NPI will be on the prescription record, billing and payment will default to the pharmacy's NPI.
*Taxonomy Classification Add Taxonomy Classification Provider Type: Select Pharmacy Services Provider

 

Added sections will auto-populate Taxonomy Classification - 183500000X - Pharmacist   
*Taxonomy Classification Add Taxonomy Classification Classification: Select Pharmacist
*Taxonomy Classification Add Taxonomy Classification
 Area of Specialization: Select None Click Add
Accreditation Add Accreditation OPTIONAL For pharmacists enrolling as OPR lite Providers using taxonomy 183500000X, Accreditations and Certificates are OPTIONAL. Enrolling pharmacists can choose to skip or enter information in these sections at their discretion.
Accreditation Add Certification OPTIONAL For pharmacists enrolling as OPR lite Providers using taxonomy 183500000X, Accreditations and Certificates are OPTIONAL. Enrolling pharmacists can choose to skip or enter information in these sections at their discretion.
Accreditation Add License License Agency: Select Board of Pharmacy DO NOT CHOOSE State Board of Pharmacy
Accreditation Add License License Type: Select Licensed Pharmacists and Certified Immunizer Medicaid will check Licensure and Immunizing Certification with the NC Board of Pharmacy records. Ensure your Board records are current to prevent delays in application approval.
Agents and Managing Employees Relationship Disclosure Does the applicant have any agent(s) and/or managing employees Select: NO  
Provider Supplemental Information Work History   Pharmacists must provide a 5-year work history. If there are gaps in employment, sign and date a Word document explaining the reasons (e.g. took a year off to raise children) and upload it at the end of the application. Failure to do so may result in delays as Medicaid may contact you for the missing information before approving the application
Provider Supplemental Information Education   Uploading of Transcripts is NOT Required
Provider Supplemental Information

Current Malpractice Insurance Coverage

Do you have malpractice insurance or are you covered under a federal tort?

 Select: YES  Carrying professional liability coverage IS required. Uploading a copy of your insurance face sheet or COI is NOT required