NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

1

Beginning July 1, 2013, NC Medicaid converted to a new system called NCTracks. NCTracks replaced the historical management information system used by the Division of Medical Assistance. As part of this change, medication related prior authorizations are now processed by a new vendor, CSC, which offers the ability to submit PA requests via a web-based application, the NCTracks provider portal.

PA requests submitted via the NC Tracks provider portal have the potential to be approved real time, and the approval is available immediately for pharmacy claims processing. This method should be utilized whenever possible for PA requests.

To enter an electronic prior authorization request, log into NCTracks using your NCID: https://www.nctracks.nc.gov/ncmmisPortal/login.

Electronic PA Submission

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

2

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

3

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

4

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

5

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

6

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

7

NC Medicaid-Electronic Prior Approval Process (PHARMACY) Management Information System (MMIS)

8

Manual PA Submission CSC also accepts fax-based PA requests, which have a 24 hour turnaround time. Please do the following to expedite the review of fax requests:

1. Use the new fax forms available through NCTracks. The new forms are marked with a large

‘CSC’ in the top left hand corner and are available at: https://www.nctracks.nc.gov/content/public/providers/pharmacy/forms.html

2. Be sure that the NPI number of the prescribing provider is an enrolled provider with NC Medicaid

3. Fax the request directly to the newly available pharmacy PA line: 866-246-8507.

Further information is available via the following website: www.nctracks.nc.gov

Cheryl A. Viracola, PharmD Network Pharmacy Programs Coordinator Community Care of Wake & Johnston Counties Office: 919.792.3661 Fax: 919.792.3670

Stephanie Craycroft, PharmD Network Clinical Pharmacist Community Care of Wake & Johnston Counties Office: 919.792.3672 Fax: 919.723.9332 Angela McGee, PharmD Network Clinical Pharmacist Community Care of Wake & Johnston Counties Office: 919.792.3664 Fax: 919.510.9162