AlphaMCS Downtime
AlphaMCS will be unavailable on November 8, 2017 from 5 p.m. until approximately 7 pm. This is for a quick maintenance update for AlphaMCS. No other systems will be affected.
Nurse Practitioner Credentialing Reconsideration
Partners’ Credentialing Committee, in conjunction with Partners’ Chief Medical Officer, determined at its August meeting that there were no gaps in Partners’ network coverage supporting a waiver of the credentialing criteria for Nurse Practitioners (NPs) set forth in Joint Communication Bulletin (JCB) #253.
However, based on feedback from providers and an outcry for reconsideration of this decision, Partners’ Credentialing Committee re-opened this issue for further discussion in October. The decision was made to allow Partners to conduct additional research on the need for allowing a waiver.
Partners is seeking information on prescriber capacity and information to inform the credentialing committee around gaps and needs. Providers are asked to offer feedback via survey by November 10, 2017. Click here to for the survey.
Attention Directly Enrolled Licensed Independent Providers—Post Payment Review
Partners Behavioral Health Management will conduct a post payment review of consumer treatment records from Directly-Enrolled Licensed Independent Providers (LIPs). Those LIPs who have a contract with Partners and are actively providing services will be directly contacted. This review will not include prescribers.
Each LIP will receive a HIPAA secure email providing details of the clinical documents selected for review and how they are to be submitted. Ten business days will be allowed to provide the selected documentation to Partners.
If you have questions, please contact Kathleen Meriac, Specialty Review Unit, at 704-884-2571 or email to kmeriac@partnersbhm.org.
DMA Claim Denials—Place of Service Code 02
Place of Service code 02 is not currently valid in NCTracks. The Division of Medical Assistance (DMA) is currently researching this change, but there are no immediate plans. If DMA decides to add this place of service code, NCTracks will need modifications to accept it and to process/edit claims and encounters correctly. This would take some time and would impact most of the provider community. There would be multiple communications that would go out if the code is added (i.e. a Joint Communication Bulletin). Partners will keep you updated as we learn more.
Attention Providers regarding ASOUD Target Population
In working with, and with direction from the Division of Mental Health, Partners Eligibility and Enrollment Department is end-dating the Adult Substance Opioid Use Disorder (ASOUD) target population as we have drawn down all funds. If consumers are eligible for another target population, please ensure they are enrolled. This direction is given to all providers except our designated Opioid Treatment Providers.
In addition, we will not accept any new enrollments into ASOUD for any provider at this time. If we are notified by DMH that we will be receiving additional dollars, we will be contact providers immediately.
Roundtable Discussion on Community Navigator Service Delivery—Tuesday, November 14
Partners strongly encourages all Innovations providers that provide, or want to provide, Community Navigator services to join us for a roundtable discussion on Tuesday, November 14, 2017 from 9:30 a.m.-12 p.m. in Partners’ Hickory Office, Multi-Purpose Conference Room, 1985 Tate Blvd. SE, Hickory, NC.
Partners would like to share some consumer and family survey data with the providers of this service to start a conversation on what appears to be working well, and where we need to make some service improvements. Some other agenda items will include:
- Responsibilities of the Community Navigator, including the Community Transition Service
- Service enrollment data and our goal to grow this service
- Current Provider capacity
- Examples of Success stories
- Discussion regarding consumer goals and objectives
- Discuss how to eliminate or reduce barriers to providing this service; quality improvements
Partners would also like all current Innovations Community Navigator Providers to make sure you are also enrolled to deliver Innovations Community Transition Services. If not, please work with your Provider Specialist to submit a Request for Nomination form to do so, as soon as possible.
IDD Care Coordination looks forward to working with our providers on expanding this service and ensuring that it is being delivered to meet our consumers’ needs. Thank you in advance for your participation.
Provider Council to meet November 17, 2017
Partners’ Provider Council meeting has been changed due to the Thanksgiving holiday. The Provider Council will meet on Friday, November 17 from 9:45 a.m.-12 p.m. at 1985 Tate Blvd. SE, First Floor Conference Room, Hickory, NC 28602.
Feedback Requested! New Service: Dialectical Behavioral Therapy
Partners will be adding Dialectical Behavioral Therapy (DBT) to our Medicaid service array. We have developed a service definition and would like provider input as we prepare to operationalize. Providers are asked to please review the DBT service definition and email Vanessa Anderson at vanderson@partnersbhm.org with your feedback. We will be accepting comments through November 30, 2017.