Issued: February 9, 2023
What is happening?
In Provider Communication Bulletin #137, Partners announced changes to the benefit limit for Rapid Response Bed Therapeutic Foster Care (TFC). These changes were effective on Feb. 1, 2023 and apply to new or initial requests for Rapid Response Bed TFC. You can access the full article at https://providers.partnersbhm.org/provider-communication-bulletin-137/#3
What do providers need to do?
Providers who want to make referrals for placements should:
- Call: 336-527-3254
- Email: firstname.lastname@example.org
If a member has already been placed in a Rapid Response Bed and there is no Care Manager assigned, please submit Care Management Referrals for Rapid Response Bed TFC to MHSU Targeted Case Management (TCM) Screening and Referrals by calling the Care Connect line at 704-842-6311 or email MHSUTCMScreeningandReferrals@partnersbhm.org.
What does this mean for providers?
Changes that went into effect on Feb. 1, included:
- Pass-through of 30 days for both Medicaid and State-funded Rapid Response Bed TFC submissions.
- First concurrent authorization request for both Medicaid and State submitted for 30 days.
- Second concurrent authorization request (and beyond) for Medicaid is submitted every 15 days.
- Treatment Plan signed by guardian and licensed clinician submitted by first concurrent authorization for Medicaid requests.
- Discharge/transition plan submitted by first concurrent authorization for Medicaid requests. Updated Discharge/transition plan by second concurrent authorization and every subsequent request.
What if providers have other questions?
If you have additional questions regarding prior authorization submissions, please contact the MHSU Utilization Management Workgroup by calling 704-842-6436 or email UMquestions@partnersbhm.org.