New User Guide for Resolving Claims Pended Due to Incorrect Location

When a claim is received with an incorrect Billing, Rendering, or Attending Provider Location, the claim is pended in NCTracks.  This occurs when the provider location submitted on the claim does not match the location(s) in the provider record.  The process is for a secure message to be sent to the provider’s NCTracks Message Center Inbox in the provider portal, with a link to a screen that will enable the provider to select the correct Provider Location from a drop down list.  The claim is then released to continue processing.  This approach allows a provider to correct the claim, rather than having it deny for incorrect Provider Location.  This functionality was not turned on at go-live, but is being activated this weekend.  Providers who have claims pended for incorrect location will begin to receive notifications in their NCTracks secure Message Center Inbox on Monday, January 27.  There will be one message for every pended claim.  A new User Guide, “How to Update a Claim in the Pend Status resulting from an Incorrect Billing Location,” has been posted to the Provider User Guides and Training page of the NCTracks Provider Portal under the heading of Claim Submission.  This user guide provides step-by-step instructions for correcting the pended claims relating to an incorrect Billing, Rendering or Attending Provider Location.  The address on the pended claim must be corrected to continue processing the claim.  The correct address is required in order for the claim to be validated and priced appropriately for the provider location submitted.