Tuesday, July 07, 2009

NC Medicaid Provider Enrollment : new private company! takes mental health provider information: DMA/EDS/ CSC in same mix

If you want to change anything about your provider status as a mental health provider accepting Medicaid in NC (DMS), note that EDS---- not any other entity---- is still doing this. (OH, EDS will send you the 'welcome letter': that's efficiency for you: one part of the Medicaid monies goes to EDS; one goes to CSC; one goes to the state; and who knows who else has their hand in the pie).

This new private company, CSC, does the provider enrollment management; another private company, EDS, tries to manage, some pieces (after waiting for 10 minutes, the CSC guy tells me to go back to EDS)......

So, I asked for the supervisor and he somehow came up w/ this link which is associated w/ EDS which of course is associated w/ provider enrollment matters (which CSC has been stated to manage): http://www.ncdhhs.gov/dma/forms/eft.pdf.

WHOOPEE! One hour on the phone and I get to the Electronic Funds transfer form.

Oh, and more information will be required of providers creating more work for mental health providers e.g., criminal background checks, etc.----yet more paperwork. (see below, FAQ).

And the payments are now irregular since CSC came online. No one at the EDS line (1 800 688 6696) knows ANYTHING about why this has taken place. For the past two years, when I would submit a very efficient webclaims payment request (easiest part of mental health billing), I would get paid like clockwork the following Wednesday when I submitted on the prior Thursday by 5 pm. This past submission, created on June 25, 2009, was not paid until today, July 7.


After April 20, 2009, a company (a large contract obtained by someone associated w/ NC Medicaid/ NC DHHS you can bet) called Computer Sciences Corporation is whom you need to contact.

You look at the NC website and you think, OK, part of state government. Nope. Behind the link (http://www.nctracks.nc.gov/) is a private company (remember: we're trying to strangle government so that we can pad private pockets).

The FAQ of the web site takes you to the information:

1. Who is CSC?

CSC is the entity that has assumed the Medicaid provider enrollment, verification, and
credentialing (EVC) activities previously performed by DMA Provider Services.

2. What is the EVC Call Center?
The EVC Call Center is CSC’s dedicated Medicaid provider enrollment, verification, and
credentialing center for providers to inquire on the status of their Medicaid applications
or change requests. The Call Center staff also assists providers with questions
regarding completion of enrollment and change forms. The EVC Call Center hours of
operation are 8:00 a.m. to 5:00 p.m., Monday through Friday, except for State approved

3. How can I contact the EVC Center?

Beginning April 20, 2009, you may contact the EVC Call Center as follows:
EVC Call Center Toll Free Number 866-844-1113
EVC Call Center Fax 866-844-1382
EVC Call Center E-Mail Address NCMedicaid@csc.com
CSC Mailing Address NC Medicaid Provider Enrollment
PO Box 300020
Raleigh NC 27622-8020
CSC Site Address NC Medicaid Provider Enrollment
2610 Wycliff Road
Suite 102
Raleigh NC 27607-3073
CSC Website Address http://www.nctracks.nc.gov

4. Where can I find more information about the new enrollment/credentialing
You can obtain information from the DMA website
(http://www.ncdhhs.gov/dma/provider/mmis.htm) as well as the CSC website

5. Where can I access applications for new enrollments?
Providers can continue to access applications from a link on DMA’s website at
http://www.ncddhs.gov/dma/provenroll/ or directly from CSC’s website at

6. Will the enrollment process change since there is a new vendor?
No. At this time the enrollment process will remain paper-based.

7. Can I complete my application online?
A web-based application will be available to providers in late summer of 2009. As this
date approaches, there will be more information available.

8. How long does it take to process a provider enrollment package?
Once a completed enrollment package is received in the EVC Call Center, it should take
approximately 2 to 3 weeks to process.

9. How will I know that my application has been received?
The receipt of your application will be acknowledged by e-mail or in writing.

10. How can I check the status of my enrollment package?
Beginning April 20, 2009, you may contact the EVC Call Center at 866-844-1113 to
check the status of your enrollment package.

11. How will incomplete applications be processed?
Whenever possible, CSC will communicate via e-mail if missing or additional information
is needed from providers.

12. How will I be notified once I am enrolled?
Once you have been approved for participation in the N.C. Medicaid Program, you will
receive a Welcome Letter from EDS.

13. What happens to an enrollment application that is submitted to DMA before
April 20, 2009?
All enrollment packages that are not processed by DMA prior to April 20, 2009, will be
screened for completion by DMA staff. If all information is complete the application will
be forwarded to the EVC Call Center for completion. If an application is incomplete it will
be returned to the provider to complete and send to CSC.

14. What happens to an enrollment application that is submitted to DMA after
April 20, 2009?
All enrollment packages that are received by DMA after April 20, 2009, will be forwarded
to the EVC Call Center for completion.

15. Will existing Medicaid providers be required to re-enroll?
No. However, CSC will verify information in the Medicaid provider file and will credential
providers who have not been not credentialed in the last 14 months.

16. As a currently enrolled provider will I be required to complete a new or additional
enrollment application?
No. However, each provider must verify information in the Medicaid provider file and
furnish additional information on ownership and criminal background as required by
Federal and State regulations. CSC will notify each provider prior to initiating the
verification and credentialing process and will request providers to complete and return
the forms within 30 days.

17. Will DMA allow providers that are credentialed by other agencies to be
grandfathered and avoid credentialing by CSC?
No. DMA has determined that other credentialing agencies do not collect all required
information needed to satisfy all federal and state requirements for Medicaid enrollment.
Since CSC will source verify the credentials of providers, providers will not be required to
submit copies of licenses, certifications, accreditations or endorsements.

18. Will my Medicaid claims payments be impacted when CSC begins processing
applications on April 20, 2009, or when CSC begins verifying information for
currently enrolled Medicaid providers?
No. There will be no impact to claims submitted to EDS for processing and payment will
not be impacted. EDS will continue to process all Medicaid claims until August 2011


Right now, I am sitting on a 10 minute plus hold waiting to find out where the 'change of banking information Electronic Funds Transfer ' form is.

Given that it took CIGNA Government Services 6 months to change my address about 1.5 years ago, I figure this will (NOT) be a snap.

There will be little success as associated w/ mental health care in terms of efficiency until there are efficient systems undergirding authorization/ utilization / billing.

Some investigative reporter should figure out who got them the contract.

WAIT! WAIT! Someone answered the phone. He did not identify his name (always get the name). The information about the Electronic Funds Transfer is not on the NC Tracks website, he says. OH: you need to contact EDS.

I'm contacting Rep Verla Insko & Martin Nesbitt, co-chairs of NC mental health reform committee.


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