Project Overview
In December 2008 the North Carolina Department of Health and Human Services (DHHS) awarded a contract to Computer Sciences Corporation (CSC) to develop and implement a Replacement Medicaid Management Information System (NCMMIS+) in support of healthcare administration for multiple DHHS agencies. NCTracks, the Replacement NCMMIS+, will be used by the Division of Medical Assistance (DMA), the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS), the Division of Public Health (DPH), the Migrant Program for the Office of Rural Health and Community Care (ORHCC), and the Division of Health Service Regulation (DHSR). NCTracks will process health care claims for about 70,000 enrolled DHHS providers who serve over a million N.C. citizens.
NCTracks is a multi-payer system that will facilitate provider enrollment and consolidate claims processing activities for multiple DHHS health plans. Providers enrolled in DMA, DPH, and ORHCC health plans will submit claims for covered health care services to NCTracks. Providers who are contracted by Local Management Entities (LME’s) to perform state funded MH/DD/SAS services will continue to submit their claims to the LME. NCTracks will coordinate processing among the payers to ensure the proper assignment of the payer, benefit plan, and pricing methodology for each service on a claim.
| DHHS Division | Health Plan |
|---|---|
| DMA | Medicaid |
| DMA | NC Health Choice |
| DMH/DD/SAS | State Funded Mental Health Services |
| DMH/DD/SAS | State Funded Developmental Disabilities Services |
| DMH/DD/SAS | State Funded Substance Abuse Services |
| DPH | Public Health |
| ORHCC | Rural Health |
| ORHCC | Migrant Health Program |
CSC will serve as the Fiscal Agent for DHHS and its divisions, providing operational support to manage provider and recipient call centers, prior authorization reviews, claims processing, pharmacy operations, medical policy reviews, and other administrative activities.
