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NC MA Long Term Care FL2 Form DMA372124 v1.0Recipient Information1. Recipient Last Name: 2. First Name: 3. Recipient DOB: 4. Recipient ID # 5. Recipient Gender: 6. SSN: 7. Admission Date (current
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01
Visit the official website of NCTracks (ncmmis.ncdhhs.gov) and navigate to the 'Home of NCTracks' page.
02
Click on the 'Fill out Home of NCTracks form' link to access the form.
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Fill in the required personal information, such as name, address, phone number, and email address.
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Submit the form by clicking on the 'Submit' button.
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Wait for a confirmation message or email from NCTracks regarding the submission of the form.

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Any individual or organization that requires access to NCTracks services or resources may need to fill out the 'Home of NCTracks' form.
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This may include healthcare providers, administrators, staff members, or individuals seeking information or assistance related to NCTracks.
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Home of nctracks refers to the online portal used by providers to submit claims and check on payments.
Healthcare providers who are enrolled as Medicaid providers in North Carolina are required to file home of nctracks.
Providers can fill out home of nctracks by logging into the online portal and entering the required information.
The purpose of home of nctracks is to streamline the claims submission and payment process for Medicaid providers in North Carolina.
Providers must report patient information, services provided, and billing details on home of nctracks.
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