IRIS; Claims and UM Updates; Announcements

IRIS Unavailable Wednesday, Sept. 13, 2017

The NC Incident Response Improvement System (IRIS) will be unavailable on Wednesday, Sept. 13, 2017 from 12 p.m.-5 p.m. for maintenance.  If you have questions during this time, please refer to https://providers.partnersbhm.org/incident-reporting/, or contact Kim Maguire by emailing kmaguire@partnersbhm.org or calling 704-884-2504.

Claims Update – Place of Service Code 02

• It has been determined that place of service code 02 (telemedicine) is currently invalid in NC Tracks for both Division of Medical Assistance (DMA) and Division of Mental Health (DMH) billing due to denials received upstream for State-Funded claims. Therefore, Partners has end-dated place of service 02 within AlphaMCS for services billed in conjunction with the ‘GT’ modifier. This change will convey the most accurate information in correlation with NC Tracks to prevent further denials upstream.
• Presently, DMA is researching this change, however there are no immediate plans to add place of service 02 code. If DMA decides to add this place of service, NC Tracks will forward multiple communications beforehand (including a Joint Communication Bulletin to the provider community and LME/MCOs to be able to make suitable preparations.
• Partners is identifying all claims billed with place of service 02 to re-adjudicate for appropriate reprocessing. Please refer to the service code list below, as this reflects which service shows an end date for place of service 02 per benefit plan.

Attention Providers—Psychological Evaluation for Individuals with a Primary Diagnosis of Intellectual and Developmental Disabilities.

Service Authorization Requests (SARs) for individuals with a primary diagnosis of intellectual and developmental disabilities require a Psychological Evaluation completed by a licensed psychological associate (LPA) or Ph. D.  One must be completed every five years for a child and every three years for an adult for Innovations and State funded services.

The psychological evaluation must include IQ and Adaptive Functioning assessment (testing) and confirm the diagnosis.

If you are only requesting B3 IDD services, the psychological evaluation does not need to have been completed within three to five years for children or adults.  However, the psychological evaluation that is submitted needs to represent a current clinical picture of the individual.  Partners Utilization Management can accept an update to earlier testing, if the update substantiates older IQ testing. The update may also add the adaptive functioning component.  The previous assessment and any updates will need to be submitted to Utilization Management with a SAR.

If you have questions, please contact Charity Bridges by emailing cbridges@partnersbhm.org or calling 704-884-2637.

Register for the Wednesday, September 13 Provider Webinar

Last Chance!

Date and Time: Wednesday, Sept. 13, 2017, 1 p.m., via WEBINAR
Topics to be discussed during the September 13 webinar include:

• Credentialing Update
• Provider Consortium and Outcomes Consortium Updates
• Monitoring and Technical Assistance Updates
• Value, Innovation, and Performance Program
• Whole Person Integrated Care

Registration is required: Click here to register. Once registered, you will receive a confirmation containing the webinar URL. If you have questions about this event, please contact Roanna Newton by emailing rnewton@partnersbhm.org, or calling 828-323-8054.

Registration Reopened for Upcoming Cognitive Behavioral Therapy Trainings!

Due to a technical error, registration was temporarily closed for the following Partners Training Academy sessions. The error has been resolved and registration is now open. Save your seat today!

Cognitive Behavioral Therapy Training

Wednesday, October 4 – Friday, October 6, 2017, 9:00 AM – 5:00 PM, Gastonia, NC – Registration

Monday, October 30 – Wednesday, November 1, 2017, 9:00 AM – 5:00 PM, Hickory, NC – Registration

Cognitive Behavioral Therapy (CBT) is a type of therapy that helps a person focus on his or her current problems and how to solve them. This three-day training program teaches the essentials of CBT, and prepares treatment providers to begin or continue the appropriate use of this evidence-based practice.

If you have questions regarding this, or other Partners Training Academy events, please email training@partnersbhm.org.

NC Providers Council 2017 Annual Conference

The North Carolina Providers Council will host its annual conference September 27-29 at the Sheraton Greensboro at Four Seasons. To learn more or to register, please visit http://ncproviderscouncil.org/conference/.