Remember hide and seek when you were a kid? After counting (really fast) I’d always yell out, “Ready or not, here I come!” But never, during all those childhood years playing hide and seek, did I actually pause after I screamed, “Ready or not, here I come,” and try to determine whether my opponent was, in fact ready.  Oh no!  Instead, I opened my eyes immediately after yelling “here I come,” and began my pursuit.

Today, July 1, 2013, whether you are ready or not, NCTracks has gone live.

NCTracks replaces North Carolina Medicaid’s 35-year-old billing system (MMIS).

The Office of State Auditor , run by Beth Wood, conducted a performance audit of the North Carolina Department of Health and Human Services (NC DHHS) released May 2013, which said DHHS failed to fully test NCTracks, a $484 million computer system scheduled to begin processing Medicaid claims on July 1. The performance audit period covered August 29, 2012, through March 16, 2013, the period between the start and rescheduled end dates of the main final testing phases. The audit fieldwork was conducted from February 11, 2013, to March 18, 2013.  you can find the full audit findings here.

The Key Findings of the audit were:

• The Department has failed to fully test the system, and the production testing process had flaws.
• Key decisions about the addition of 1,500 user accounts and privacy and security procedures have yet to be made, increasing uncertainty about project readiness.
• A vendor hired to oversee the project did not conduct independent verifications as expected by the federal agency that administers Medicaid, and another vendor was permitted to set its own guidelines for whether its work was acceptable.
• No formal criteria exists to determine whether the new system is ready to go-live.

Furthermore, according to the audit, of 834 “Critical Priority Test Cases” set to be performed on the new system, it failed 123. The audit says 285 of the “critical” tests, more than one-quarter, were never performed.

The audit also states that DHHS failed to adequately supervise the audit….hmmm…a common theme?

Well, regardless, NCTracks is here and live.

I have no information as to how NCTracks is working, so anyone who has already used NCTracks, let me know.

On the bright side, DHHS definitely held its number of provider workshops on education for providers regarding NCTracks.  One of my clients informed me he was in a 3-day class to learn about NCTracks. 3 days? Is NCTracks that difficult? If so, why? I can only imagine how many providers did NOT attend a workshop, considering how busy most providers are.

Other “good factors” about NCTracks…Supposedly, a provider will know almost immediately whether Medicaid will reimburse the provider for services rendered.  And the new system certainly cuts down the use of paper. Of course, these are all factors IF NCTracks is successful.

It is anticipated that NCTracks will process about 88 million claims annually valued at $12 billion from more than 70,000 providers.

But what if NCTracks fails? I’ve seen no contingency plan.  I am sure that, as with all big transitions, there will be bumps in the road.  But bumps, in this case, would mean providers not being reimbursed for Medicaid services rendered.  There are only so many bumps Medicaid providers can take. Good luck!

Ready or not, here I come!

If you have issues, the phone number for technical issues is 1-800-688-6696.