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NC Department of Health and Human Services
NC Division of
Medical Assistance
 
 

Claims

Submitting Claims

The N.C. Medicaid Program requires all providers to file claims electronically. However, there are some exceptions to this requirement.

Time Limits for Filing Claims

All Medicaid claims, except inpatient claims and nursing facility claims must be received by NCTracks within 365 days of the first date of service in order to be accepted for processing and payment. All Medicaid hospital inpatient and nursing facility claims must be received within 365 days of the last date of service on the claim.

Claims for behavioral health services provided to beneficiaries of the Piedmont Cardinal Health Plan (PCHP) catchment area must be filed with the PCHP within 90 days of the date of the service was provided.

Claims Payment

The N.C. Medicaid Program no longer issues paper checks for claims payment. Use your NCID to get to the NCTracks secure provider page to verify your EFT information. To update your EFT information, click on "Status and Management”. If you click on the "Status and Management" button and get a blank page, it indicates that you are not listed as an owner or managing employee on the provider's profile in NCTracks. The Office Administrator (OA), or an owner/managing employee who has been configured as a User Administrator will need to change your status before you can proceed.

Any updates in EFT information will trigger a pre-note transaction with the bank to verify the information submitted. It can take up to six business days to complete the EFT pre-note process. Claims adjudicated for providers who do not have valid EFT information on file will suspend for 45 days awaiting an EFT update, after which they will deny.

Claims submitted electronically by 5:00 p.m. on the cut-off date are processed on the following checkwrite.  Funds are automatically deposited into your account within four days of the checkwrite date.

Claim Status

To check on the status of a claim, call the NCTracks Automated Voice Response System (AVRS): 1-800-723-4337

Claim and Claim Adjustment Forms

For More Information

  • NCTracks Customer Service Center is available Monday through Friday, 9 a.m. through 5 p.m., at 1-800-688-6696.  The Call Center can assist providers with billing questions, electronic commerce services, and other issues.
  • For billing information specific to a program or service, refer to the Clinical Coverage Policies and Manuals.