North Carolina completed its historic transition from fee-for-service to managed care in 2024, launching Standard Plans and Tailored Plans that fundamentally changed how all NC Medicaid providers must enroll and credential.
What Is the NCTracks Portal?
NCTracks is the multi-payer Medicaid management information system operated by the North Carolina Department of Health and Human Services (DHHS) and managed by GDIT. NCTracks serves as the centralized hub for provider enrollment, credentials verification, revalidation, and claims submission.
Following North Carolina's historic Medicaid Expansion in December 2023, which expanded eligibility to more than 600,000 low-income adults, NCTracks has become the critical entry point for healthcare providers seeking to serve this rapidly growing patient base.
Step-by-Step NC Medicaid Enrollment
Register on NCTracks
Create account with NPI, Tax ID, NC license, practice information.
Complete Application
Demographics, NC license, specialties, locations, ownership disclosures, billing config.
Upload Documents
NC license, NPI, W-9, EIN, liability insurance, DEA, voided check, ownership forms.
Complete Screening
OIG/SAM, NC Medical Board verification, SBI background checks for high-risk.
Submit
Processing: 30–45 days.
Credential with Standard Plans and/or Tailored Plans
After NCTracks approval, credential with the managed care plans serving your population.
NC Medicaid Managed Care: Standard vs. Tailored Plans
North Carolina's Medicaid delivery system is divided into two distinct managed care programs: Standard Plans and Tailored Plans.
Standard Plans manage physical health, pharmacy, and mild behavioral health services. These plans are administered by statewide Managed Care Organizations (MCOs):
- Healthy Blue: Operated by Blue Cross and Blue Shield of North Carolina, holding a substantial market share.
- WellCare of North Carolina: Backed by Centene, providing extensive rural coverage.
- UnitedHealthcare Community Plan: Offering standardized statewide provider networks.
- AmeriHealth Caritas North Carolina: A prominent plan focused on health equity.
- Carolina Complete Health: A provider-led entity serving designated regions.
Tailored Plans manage integrated physical, behavioral health, and long-term services for individuals with severe mental illness, intellectual or developmental disabilities (I/DD), or traumatic brain injuries. These are managed by regional LME/MCOs:
| Tailored Plan LME/MCO | Service Region | Key Focus Areas |
|---|---|---|
| Alliance Health | Cumberland, Durham, Johnston, Orange, Wake counties | Severe behavioral health, crisis management. |
| Vaya Health | Western NC counties | Rural care integration, developmental supports. |
| Trillium Health Resources | Eastern/Coastal NC counties | Local community-based care coordination. |
| Partners Health Management | Central/Western Piedmont counties | Intellectual and developmental disabilities (I/DD). |
✔ B2B Strategy: Providers must identify their patient demographic to choose the right contracting path. If you offer specialized psychiatric or developmental therapy services, parallel enrollment with the regional Tailored Plan LME/MCO is mandatory to unlock reimbursement.
Frequently Asked Questions
How long does NC enrollment take?
NCTracks: 30–45 days. Plan credentialing: 30–60 days. Total: 60–105 days.
What changed with managed care?
NC transitioned from FFS to managed care in 2024. All providers now need MCO credentialing in addition to NCTracks enrollment.
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