Issued: May 6, 2019
Exception to Benefit Plan Limits for Inpatient Services
Partners Utilization Management (UM) allows a maximum of three days to be requested for all Medicaid (0101) and State-funded (YP820) Inpatient Service Authorization Requests (SARs).
Effective June 20, 2018, Partners began allowing an exception for SARs with a length of stay covering weekend days. Specifically, hospitals submitting SARs with a start date of Thursday can request an additional day to extend the maximum allowed days requested to four (allowing a request for Thursday, Friday, Saturday and Sunday). A continued stay SAR would have to be submitted on or by Monday.
Effective April 24, 2019, Partners has begun a similar exception for holidays that fall on a Monday. Hospitals can submit a SAR for up to four days if the SAR is submitted with a start day of Friday (requesting Friday, Saturday, Sunday and the Monday holiday). A continued stay SAR would have to be submitted on or by Tuesday.
Utilization Management Inpatient staff will remain available seven days a week, including holidays, 8:00 a.m. until 7:00 p.m. Hospitals can continue to submit SARs with any start day. All Inpatient SARs will be reviewed for Medical Necessity.
If you have questions, please contact Partners’ UM Inpatient Review at 704-842-6434.
From NC Division of Health Benefits: NCI Staff Stability Survey
Help us learn about the IDD Staffing Situation in North Carolina
The Division of Health Benefits is asking all intellectual and developmental disability (IDD) providers to please make sure (if they have not already done so) to complete the North Carolina NCI Staff Stability Survey.
This is our chance to learn about the IDD staffing situation in North Carolina and we need to hear from EVERY PROVIDER! The survey results will provide much needed information on the staffing situation specific to North Carolina.
The email invitation that went out to providers came from Dorothy Hiersteiner firstname.lastname@example.org. If you did not get the link, or need to ask questions about the survey, please email NCISurvey@dhhs.nc.gov. The NCI Staff Stability Survey will close on May 31, 2019.