Issued: July 23, 2019
Clarification to July 15, 2019 Alert—Management of Basic Outpatient Services
On July 15, Partners issued a Provider Alert announcing that it will no longer manage (require authorization) Basic Outpatient Services as of July 10, 2019. The change is effective beginning with dates of service July 1, 2019. This means that Partners’ network providers no longer need to submit a Service Authorization Request (SAR) for Basic Outpatient Services after 26 visits. Providers may continue to submit claims and receive payment for these services.
Partners will continue to monitor utilization trends of Basic Outpatient Services through a post-payment review process. For additional questions related to Basic Outpatient Services, please contact the Utilization Management work group number at 704-842-6436. For a list of service codes no longer requiring an authorization, please view the alert.
Joint Communication Bulletin #332 – State Funded Peer Support
As noted in Joint Communication Bulletin #J332, State-Funded Peer Support Services (PSS) service definition, effective August 1, 2019, the State-Funded Peer Support Services (PSS) service definition will go live and supersede any existing alternative PSS service definitions. The following Y-codes will end on July 31, 2019:
|
Code |
Description |
| YA-308 | Peer Support |
| YA-309 | Peer Support Group B3 |
| YA-343 | Peer Support Hospital Discharge & Diversion – Ind |
| YA-366 | Recovery Education Center (REC) – Ind |
| YA-367 | Recovery Education Center (REC) – Group |
| YA-375 | Peer Support Hospital Discharge & Diversion – Group |
| YA-340 | Wellness Education Group |
Agencies providing Peer Support Services will be required to use the following billing codes:
|
PSS-Individual |
PSS-Group |
| H-0038 | H-0038HQ |
To access State Benefit FY2020 documents, such as DMH Benefit Plan Eligibility, FY20 Budget Criteria, DMH Service Array, DMH BP Hierarchy and BP DX Code Array, visit https://www.ncdhhs.gov/providers/provider-info/health-care/nctracks/fy2020documents.
Mandatory Therapeutic Foster Care Services Meeting, August 27, 2019
In an effort to continually improve the network and referral system of Therapeutic Foster Care services within our community, Partners is hosting a mandatory meeting that will be facilitated by Beth Lackey, Provider Network Director and Danny Nolen, CEO of Rapid Resource for Families. The following items will be presented/discussed:
- TFC Provider Expectations
- TFC Database/Reporting Overview
- Rutherford County Provider Transitions
This session will also provide TFC providers with an opportunity for additional training, specifically on how to achieve full participation status with the Rapid Resource for Families (RRFF) database. The purpose of the RRFF database is to improve referral responses and provide outcomes that will enhance the delivery of the therapeutic foster care services.
Date and Time: Tuesday, August 27, 2019, 3:00-4:30 p.m.
Location: Partners’ Hickory Office, Multipurpose Room (Basement), 1985 Tate Blvd. SE, Hickory, NC 28602
To register, click here.
Questions? Please contact Lisa Jordan by emailing ljordan@partnersbhm.org or call 828-323-8058.