The state’s new Medicaid claims processing system, NCTracks, goes live in less than a week

Press release

From the N.C. Department of Health and Human Services:

RALEIGH – With one week remaining until NCTracks goes live on July 1, the transition to North Carolina’s new Medicaid claims processing system is well underway. The NC Department of Health and Human Services today announced successful completion of a large data transfer from the old system to NCTracks over the weekend and ahead of schedule.

This week, Medicaid claims will be paid for the final time using the old system, and NCTracks will be open for business on Monday, July 1 at 6 a.m.

“We are prepared,” said DHHS Chief Information Officer Joe Cooper, a former technology chief for a major banking institution. “Since arriving in January, our team has been working around the clock to test the technology, conduct third party reviews of the platform and reach out to the provider community to tell them about the switch. But we know that when you are replacing a 35-year-old system, there are going to be some rough patches as providers adjust to using the new system.”

Upon arriving in January, DHHS Secretary Aldona Wos brought in an independent Charlotte-based IT consultant to gauge the readiness of the NCTracks project and found the project would be ready for launch on July 1. Additionally, Maximus, a third-party reviewer reporting to the federal government since the project’s beginning, has been “green-lighting” the project for several months.

Cooper said other states that made similar, successful system conversions report two sources of disruption: unexpected technical difficulties and a learning curve for users. To fix system issues as they arise and help providers transition to the new system, DHHS and its vendor, CSC, established a centralized “command center” structure.

“We will be monitoring the situation from our command center in Raleigh by the minute, and channels have been established for proper escalation of any potential issues,” added Cooper. “Working with CSC, we have a 24/7 response team in place ready to resolve issues as swiftly as possible.”

The command structure integrates CSC’s Call Center, Operations and Infrastructure areas with the DHHS leadership throughout the transition phase. Providers will be able to reach the Call Center at 1-866-844-1113, or by e-mailing NCMedicaid@csc.com. Beginning July 1, the CSC Call Center will also take over the old system’s toll-free hotline number. Despite increased staffing and extended hours, the Call Center anticipates longer-than normal wait times. On-hold messages will automatically advise of expected wait times.

The DHHS Command Center will relay useful information to providers – from frequently asked questions about certain claim types, to times when the Call Center waits are shortest – through the NCTracks web portal, www.nctracks.nc.gov.

NCTracks replaces the state’s 35-year-old Medicaid Management Information System with the nation’s first Medicaid-based multi-payer system. NCTracks will promote information sharing and efficiencies by consolidating systems in the Division of Medical Assistance, Division of Public Health, Division of Mental Health/Developmental Disabilities/Substance Abuse Services and the Office of Rural Health and Community Care into one system. It is estimated NCTracks will save the state $35 million annually in operating costs, improve claim accuracy and have powerful new tools for managerial decision-making and reducing fraud and waste.

NCTracks will process 88 million claims per year for more than 70,000 healthcare providers, amounting to $12 billion to provide critical services to more than 1.5 million Medicaid beneficiaries.