NCTracks is not the address for a prepaid health plan. The Department of Health and Human Services runs NC Medicaid. Fee-for-service claims and enrollment run through NCTracks. Most members are in a prepaid health plan, and that plan is the payer. A Standard Plan claim sent to NCTracks as if it were fee-for-service is the wrong door. Tailored Plans cover members with serious behavioral-health needs and are a different plan type again.
NCTracks is not the address for a prepaid health plan.
The Department of Health and Human Services runs NC Medicaid. Fee-for-service claims and enrollment run through NCTracks. Most members are in a prepaid health plan, and that plan is the payer. A Standard Plan claim sent to NCTracks as if it were fee-for-service is the wrong door. Tailored Plans cover members with serious behavioral-health needs and are a different plan type again.
Medicare Part A and Part B for a North Carolina practice go to Palmetto GBA, Jurisdiction M, with South Carolina, Virginia, and West Virginia. Tennessee and Georgia use Palmetto Jurisdiction J. The contractor's name matches. The jurisdiction does not.
North Carolina is not a no-fault state. A work injury is billed to the employer's carrier under the Industrial Commission. It is not an NC Medicaid claim.
North Carolina billing fails when every Medicaid member is treated as NCTracks fee-for-service. The card names a Standard Plan or a Tailored Plan for most members. Medicare is a Palmetto Jurisdiction M file, not the Jurisdiction J file used in Tennessee.
Healthy Connections. Same Medicare contractor, Palmetto Jurisdiction M.
South Carolina medical billing TNTennCare. Medicare through Palmetto Jurisdiction J.
Tennessee medical billing USThe directory of state Medicaid programs and Medicare contractors.
Back to the state listNo. NCTracks is fee-for-service and enrollment. Standard Plan and Tailored Plan members are billed to the prepaid health plan.
Palmetto GBA, Jurisdiction M. Tennessee uses Palmetto Jurisdiction J.
The fee is a percentage of net collections. The written rate follows volume, specialty, and how much of the cycle you hand over. There is no setup fee, and the agreement is month to month. The state is not a surcharge. How pricing is set.
