NCTracks will achieve its first service anniversary on July 1 as the single system for processing claims and payments for Medicaid and other N.C. Department of Health and Human Services (DHHS) programs. In its first year, NCTracks processed 200 million claims and paid $10.3 billion to healthcare providers.
"NCTracks is working well, and North Carolina is on its way to having one of the most efficient Medicaid processing systems in the nation," said Joe Cooper, DHHS Chief Information Officer. "While consolidating several IT systems into one was a complex task, the long-term benefits of NCTracks are paying off. NCTracks delivers monthly savings to our state and pays our providers more quickly and more often."
The largest, most complex IT project in state history, NCTracks is the first public multi-payer system in the United States, replacing a 35-year-old system. NCTracks processes claims for a variety of DHHS programs, including services provided through Medicaid; the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; the Division of Public Health; and the Office of Rural Health and Community Care. By combining these claim systems into a single streamlined system, NCTracks provides savings of $3 million per month.
DHHS has worked closely with CSC, the fiscal agent, since January 2009 when development of NCTracks commenced. "We've made huge strides as a team this year," said Charles F. Koontz, vice president and general manager of CSC's government health agencies unit.
"This anniversary marks a significant moment in time where together, we've redefined the process. Now, providers can access multiple systems through a single sign-on portal for a near real-time view of claims that are being processed faster and more efficiently. We look forward to continuing to expand on our successes over the coming year."
The benefits of NCTracks include faster claim processing and 50 paydays for healthcare providers per year, compared with 42 under the former system. More than 98 percent of electronically filed, approved claims are paid within a week. NCTracks also automates many processes that were previously manual.
Another benefit of NCTracks is the use of taxonomy codes, which are detailed codes that coordinate specific information on a claim, including confirmation of the providers' credentials to bill for various services. Taxonomy codes enable better analysis of the types and costs of Medicaid healthcare providers. "After the first couple of months, most providers adjusted to using taxonomy codes. In the long run, other states that use taxonomy-based systems have confirmed that it helps reduce healthcare fraud and abuse," Cooper added.
Part of the success of NCTracks can be attributed to improvements with the call center. The call center, available as a resource to assist providers with claims processing, is reaching best-in-class performance statistics for government and private industry. On most days, calls are answered in less than 30 seconds. Today, 86 percent of callers get their issues resolved in the first call.
"I'm proud of the collaboration between the technical teams at DHHS and CSC, healthcare providers and associations throughout the past year," said Cooper. "A system of this size and scope doesn't come without challenges, but we have witnessed a steady and impressive improvement over the last 12 months. DHHS staff expects to build on the success of NCTracks and continue providing benefits to the state."
Click here to view NC Tracks 1-Year anniversary video.