What does NCTracks stand for?

What does NCTracks stand for?

NCTracks is the new multi-payer Medicaid Management Information System for the NC Department of Health and Human Services. It has three separate portals for specific internet access to different sectors of the business (Providers, Recipients and internal operations needs).

Does NC Medicaid cover OTC drugs?

NC Medicaid may consider coverage for specific OTC products and OTC medications not available as legend drugs that provide cost-effective treatment as well as cost- effective alternatives to legend drugs covered by Medicaid.

Does NC Medicaid cover prescriptions?

About the Pharmacy Program The North Carolina Medicaid Pharmacy Program offers a comprehensive prescription drug benefit, ensuring that low-income North Carolinians have access to the medicine they need.

Does NC Medicaid cover weight loss medication?

NC Medicaid explicitly excludes coverage for weight loss and weight gain drugs.

What is NCTracks prior approval?

Prior approval (PA) is required for certain drugs prescribed to N.C. Medicaid and Health Choice recipients. Refer to the Prior Approval Drugs and Criteria page for specific criteria. Providers may submit requests via fax, phone or through the secure NCTracks secure provider portal.

How do I file a claim with NCTracks?

Go to the NCTracks Provider Portal home page. On the left navigation bar, click Claims. On the sub menu choose Adjustment and Refunds. Open the PDF file “How to Submit Claim Adjustment and Time Limit and Medicare Overrides” and follow the steps.

Does Medicaid cover tummy tucks in NC?

Medicaid was designed to deal with situations that are medically necessary for the patient. For example, if you need to remove a malignant tumor or if you need to get surgery to manage a hernia. Since tummy tucks are typically only cosmetic, they typically won’t be handled by Medicaid.

Will NC Medicaid pay for skin removal?

Surgical removal of this skin and fat for solely cosmetic purposes is not covered. Refer to NC Medicaid Clinical Policy 1-0-1 Reconstructive and Cosmetic Surgery found at https://medicaid.ncdhhs.gov/ for excessive skin removal criteria. psychosis, binge-eating disorders, current drug and or alcohol abuse.

What does suspended mean on NCTracks?

S – Suspended. This status indicates that your PA is new and being reviewed by a clinical specialist for a decision. T – Terminated. This status indicates that your PA request was approved at one point.

Will NC Medicaid pay for Wegovy?

Have a valid prescription for Wegovy. Cannot be enrolled in any federal or state health care program, such as Medicaid, Medicare, Medigap, VA, DOD, or TRICARE. Cannot seek reimbursement through any such federal or state healthcare programs.