Providers are contractually required to submit billing electronically through Partners’ AlphaMCS portal. AlphaMCS is a web-based system that is available to Partners Providers upon completion of a Trading Partner Agreement (TPA).
Providers must submit claims through the AlphaMCS Provider Portal using:
- an approved 837 submission or direct entry onto CMS 1500 forms for outpatient services, or
- UB04 for hospital inpatient/emergency department services.
The AlphaMCS Provider Portal Manual outlines very specific instructions on what is needed to complete a claims form. Details regarding claims submission are available in the Partners Provider Operations Manual.
Inquiries regarding claims status should be directed to the Partners Claims Department staff.
You can contact the Claims Department directly by calling 704-842-6486 or email email@example.com for assistance.
Timely Filing Override Requests
Timely filing override requests should only be submitted for the following reasons. The requests are reviewed for consideration.
Timely Filing Requests should be sent directly to firstname.lastname@example.org prior to submitting the claims.
- Retroactive Medicaid: Claims based on retroactive Medicaid eligibility must have authorization requested within 30 days. Timely filing request and submission of claims must be within 90 days of the date modified in NCTracks for eligibility date range.
- Retroactive Medicare/TPL: If claims are recouped due retroactive Medicare/TPL, the claim can be resubmitted once the claim has been resubmitted to other insurance. The only exception is claims that are not within the Fiscal Year for State benefit. Timely filing request and submission of claims must be within 90 days of recoupment.
- NC Tracks License update/addition: Request must be submitted within 30 days of date modified in NCTracks.
- NC Tracks NPI/Taxonomy update/addition: Request must be submitted within 30 days of date modified in NCTracks.
- Site update: Request must be submitted within 30 days of update.
- AlphaMCS system issues identified by Partners
- Eligibility issue with NC Fast/NC Tracks: Request must be submitted within 30 days of date modified in NCTracks.