Prior Approval
The KB where you can locate a phone number to NCLiftss.
What is Outside PA Vendors?
The KB that lists acceptable forms of documentation for a name change.
What is KB Documents Required: Process to Update a Name, Date of Birth (DOB), SSN on a Provider's Record.
The KB that has scripting and documentation for what to do if your call drops before verifying the caller.
What is KB Dead Air Script and Notation Guidelines for Silent Calls.
One of the KBs that lists the options for obtaining claim status.
What is KB Claim Status Request?
The KB that tells us the date Tailored Plans started.
What is KB Tailored Plans Launch July 1, 2024 (Provider Calls)?
The KB that answers if a PA is required for admission via the ER.
What is Prior Approval - Admission through Emergency Room?
The KB that shows the Federal Fee amount for 2025.
What is KB Federal Fee Payment Process and Amount.
Where you can locate the 6 digit client ID number for Language Line calls.
What is KB Language Line.
The KB you can use to help a caller determine if they should submit a claim as a replacement or Void.
What is KB Submitting a Void or Replacement Claim?
The KB you should use if a recipient calls wanting to updating their primary insurance on file.
What is KB When to Refer Beneficiaries to Health Management Systems (HMS)?
The KB that tells you what a "reject" status is on a PA.
What is KB Prior Approval Request Status - What Does It Mean?
The KB you can research to see who receives a notification when EFT or the OA is attempted to be changed.
What is KB Security Measures for Electronic Funds Transfer (EFT) and Office Administrator (OA) Changes?
One of the KBs that should be used if a caller has a question about the MFA process changing.
What is KB Multi-Factor Authentication (MFA) Integration Phase 2 (2024) - General Information?
The KB that should be used when a caller is asking about denial: edit 00225 PA RECORD DOES NOT MATCH CLAIM CRITERIA.
What is KB PA Record Does not Match Claim Criteria for denture codes D5211, D5212, D5130, D5140, D5110, and D5120?
The KB that should be used when a caller asks us to send out a letter stating that they are enrolled for NC Medicaid.
What is KB Verification of Enrollment in NC Medicaid?
The KB that tells you what to do if a caller requests to change the NPI on a Prior Approval.
What is KB Requesting Changes to Prior Approvals?
This KB will tell you what information you must document in a ticket if someone is requesting an Authorization Code for an individual provider.
What is KB Authorization Code for CEP Registration and OA Change Process-Individual Provider?
The KB you should follow if you receive a call from AI or robocaller.
What is AI (Artificial Intelligence) or Robocaller Generated Calls?
This KB provides a contact for Providers if they are having issues with any Health Plans (PHPs) after contacting the PHP and NCTracks.
What is KB Provider Ombudsman Services at Launch of Managed Care and Beyond?
The KB that tells us what the User Roles and abilities are.
What is KB Office Administrator (OA) and NCID User Roles in NCTracks?
The KB you should use if the claim denies for EOB 00023, REQUIRED PA MISSING.
What is KB Claim Denials Due to Change in Benefit Plan from Prior Approval Request?
One of the KBs you should use if the caller wants to know what steps to take if they have been terminated due to not completing reverification.
What is KB Provider Termination- Reverification Not Completed?
The KB that will help you achieve a good QA score if followed.
What is KB Optional Call Flow to Assist in Scoring Well for Quality?
Where to locate Office of the Controller phone number.
What is KB: Claim EOB 00182 - Claims Suspended for Financial Review (Bad Debt Status).
The KB that helps us determine which license types will automatically update in NCTracks.
What is KB Board License to Automatically Update in NCTracks?