Partners’ administrative offices will be closed on Tuesday, December 24 through Thursday, December 26, 2019, as well as Wednesday, January 1, 2019.
Our Access to Care Call Center will be available 24 hours a day and our Utilization Management Acute Services Team will be available from 8 a.m.-7 p.m. during the holidays.
Request for Changes to Enrolled Member Record
All requests for changes to a currently enrolled member’s record must be made by submitting an Update Request via AlphaMCS. Providers should note that update requests cannot go back further than 90 days from the date of submission. If an update request is submitted outside of the 90-day period, the effective date(s) will be changed to retro back 90 days. This applies only to diagnosis, benefit plans and substance use. State layer funding effective dates cannot be changed outside of the seven-day enrollment period rule.
If you have questions, please contact Becky Ford, Enrollment and Eligibility Supervisor, by emailing email@example.com or calling 336-527-3211.
Providers offering appointments through the AlphaMCS Slot Scheduler need to ensure that appointments are scheduled correctly. Please make sure that your appointments account for the:
- Correct operating hours over holidays and vacations
- Type of funding and clients served (Medicaid or State)
Providers should upload appointments for the next month at least two weeks prior to the beginning of the month. In addition, please inform Access to Care if you are adjusting hours due to operational changes, such as holidays or inclement weather. If you have any questions, please contact Access to Care at 1-888-235-4673.
UPDATED: Partners Inpatient Review Form
Partners Utilization Management (UM) has revised the Inpatient Review Form. Providers should begin using the updated form at this time. The form is located at https://providers.partnersbhm.org/hospitals-working-partners/. This form can be attached to Service Authorization Requests (SARs) for Medicaid and Non-Medicaid funded Inpatient services. If not using the Inpatient Review Form, the provider must include all information requested on this form in the SAR justification.
If you have questions, please contact the UM Acute Services Team at 704-842-6434.
Back-Up Staffing Tutorial Available
Partners has added a video to its Provider Knowledge Base to assist providers in navigating the AlphaMCS module when entering back-up staffing reports. Providers can access the video by visiting https://providers.partnersbhm.org/back-up-staffing/.
Registration of Interest: NC Medicaid Children and Youth Services (Surry and Yadkin Counties) ROI #1219-001
Partners Registration of Interest #1219-001 “NC Medicaid Children and Youth Services (Surry and Yadkin Counties) will be used to specifically identify any mental health/substance use providers interested in and qualified to participate in trauma initiatives in Surry and Yadkin counties. Partners is specifically seeking mental health provider agencies and/or DSS agencies with clinical teams willing to have their clinical staff (up to five clinicians and one clinical team lead) trained and certified, as well as, maintain certification in order to participate in the project. Certification is awarded by Benchmarks after the designated clinical team leader and clinical team complete the required three-day training and demonstrate competence in the required modalities. Each clinical team will be trained in the use of the assessment, the impact of trauma, how to utilize the standardized measures and the Trauma-intensive Comprehensive Clinical Assessment (TiCCA) template. Clinicians that demonstrate proficiency through North Carolina’s Child Treatment Program (NC CTP) rostering or through their professional license will be exempt from some aspects of clinical training. Clinical team leaders will receive additional training in facilitative administration including operational components. Completion of the training, in addition to ongoing fidelity monitoring, will deem a clinician as certified.
Interested providers should visit https://providers.partnersbhm.org/request-for-services/ to view the ROI and access the required documents.
Responses to this ROI are due by 5 p.m. on Thursday, January 2, 2020. All questions should be directed to Lisa Jordan, firstname.lastname@example.org.
Providers should send all inquiries to email@example.com so they are handled in the most efficient manner. Please do not send email directly to individual employees.
Explanation of Benefits Requests for Coordination of Benefits Claims: As a reminder, Partners requests copies of the Explanation of Benefits for members/claims submitted indicating Coordination of Benefits. The request will originate via email from Partners Claims staff. Once requested, please submit the information, via a secured email, prior to the date indicated in the emailed request. If a response is not received, the original claim payment will be recouped.
|November 2019: Medicaid—Number of Days to Process and Pay All Claims|
|Received Date to Paid Date:||8.9|
|Top Five Medicaid Claim Denials for November 2019|
|Claim Denial||Provider Recommended Action Steps|
|Service is not authorized||Verify Service Authorization for the consumer. Contact Utilization Management.|
|Duplicate Claim||The claim has previously been submitted and adjudicated. Do not refile.|
|Claim received after billing period.||Write off charges as non-billable. Do not rebill.|
|Billing Taxonomy submitted is not associated with billing NPI.||Rebill claim with correct taxonomy/NPI information.|
|No coverage available for Patient/Service/Provider combo
|Go to Patient -> Patient Search and search for the patient in question. Check the insurance to ensure the patient has effective insurance covering to date of service submitted on the claim. If this appears to be correct, contact the MCO for further assistance.|
Suspension Notices to Members: NC Medicaid began mailing notices about the suspension of Medicaid Managed Care to beneficiaries on Friday, December 6.
View the notification
Joint Communication Bulletins, which are issued by the NC Department of Health and Human Services, can be found at https://www.ncdhhs.gov/divisions/mental-health-developmental-disabilities-and-substance-abuse/joint-communication-bulletins-2019.
JCB#J349 – Executive Order No. 97: Protecting Minors from Conversion Therapy: JCB #J349 informs LME-MCOs of a change to the following NC Medicaid Behavioral Health clinical coverage policies (CCPs) and Division of MH/DD/SAS state-funded service definitions, as part of Executive Order No. 97: Protecting Minors from Conversion Therapy:
Medicaid Clinical Coverage Policies:
- Enhanced Mental Health and Substance Abuse Services
- 8A-1. Assertive Community Treatment (ACT) Program
- 8A-2. Facility-Based Crisis Service for Children and Adolescents
- 8A-6. Community Support Team
- Inpatient Behavioral Health Services
- Outpatient Behavioral Health Services Provided by Direct-Enrolled Providers
- 8D-1. Psychiatric Residential Treatment Facilities for Children Under the Age of 21
- 8D-2 Residential Treatment Services
Division of MH/DD/SAS State-Funded Service Definitions:
- 2019 State-Funded Enhanced Mental Health and Substance Abuse Services
- State-Funded Assertive Community Treatment (ACT) Policy
- State-Funded Facility-Based Crisis-Child
- State-Funded Community Support Team (CST)
- State-Funded DMH/DD/SAS Service Definitions 2003-2019
- State-Funded Peer Support Services
- State-Funded Inpatient Behavioral Health
- State-Funded IPS-Supported Employment
- State-Funded Transition Management Services
- State-Funded Critical Time Intervention (CTI)
- State-Funded Developmental Therapy Services
JCB #J348 – Substance Use Disorder Institution for Mental Disease Clarification: #J348 SUD IMD Clarification reminds LME-MCOs, effective July 1, 2019, services in IMDs for SUD treatment are allowed without a day limit per Section 6.23 of the contract. View the bulletin
NC DHB Releases, Requests Comment on Tailored Care Management Provider Manual and Application Process: The NC Division of Health Benefits (DHB) has released the draft Provider Manual for Tailored Care Management and application process for comment. Providers are reminded that although the implementation of managed care has been suspended by the Department of Health and Human Service, work continues for the design of Tailored Plans. Visit https://medicaid.ncdhhs.gov/providers/programs-and-services/behavioral-health-idd-tailored-plan for details and to access the draft documents.
Three New Medicaid Bulletin Articles Available as of December 10, 2019: The NC Division of Health Benefits has published three Medicaid Bulletin articles dated December 10, 2019:
- Relocation of Evaluation and Management (E&M) Fee Schedules Effective November 8, 2019
- NC Medicaid Electronic Health Record (EHR) Incentive Program Announcements
- New Coverage, Prior Approval and Billing Requirement for CAR-T Cell Therapy (KYMRIAH & YESCARTA)
Providers are encouraged to review this important information at https://medicaid.ncdhhs.gov/providers/medicaid-bulletin.
Changes to Required Documentation for Provider Record Updates:
Effective November 13, 2019, IRS W-4 form copies are no longer accepted as a source of required documentation to update a Social Security Number (SSN) on provider records. However, a copy of an IRS W-2 form is now accepted. Additionally, a copy of license/accreditation reflecting a new organizational/group name change is NOT accepted to change the organization/group legal name. The only document accepted for this change is a copy of the IRS letter. Please refer to the chart for an updated list of required documentation for changes to a provider’s record. Click here to learn more
NCTracks Tip #5: System Requirements:
When non-compatible browsers (such as Apple’s Safari) are used to access NCTracks, data may be displayed incorrectly or incompletely. For best results, NCTracks recommends using one of our fully supported browsers. To see our supported browser list and more details, please see the December 6, 2019 announcement. Please note that Apple’s Safari is not compatible.
Reminder: Call Center Closed for Christmas and New Year’s Day Holidays:
NCTracks will follow the State schedule in observing the Christmas holiday. The NCTracks Call Center will be closed on Tuesday, December 24 through Thursday, December 26, 2019. The NCTracks Call Center will also be closed on Wednesday, January 1, 2019. (The Pharmacy Prior Approval Unit will be open holiday hours from 7:00 a.m. to 6:00 p.m. on December 24-26 and January 1.)
Also, as previously announced, in keeping with the published NCTracks checkwrite schedule, there will be no checkwrite on December 24, 2019. However, since the first checkwrite of 2020 will occur on January 7, the State has added an additional checkwrite (December 31, 2019) to the 2019 checkwrite schedule to reduce the time gap between checkwrites. The 2019 and 2020 checkwrite schedules can be found under Quick Links on the NCTracks Provider Portal home page.
Partners Licensed Independent Practitioner Collaborative
Partners will host its next Licensed Independent Practitioner (LIP) Collaborative at 12 p.m. on Wednesday, February 12, 2020. This collaborative focuses on the information relevant to the Licensed Independent Practitioners in the Partners Provider Network. Register Now
Partners Training Academy
All Partners Training Academy sessions are free to registered attendees. Register in advance at www.PartnersTraining.com. If you have any questions about Partners Training Academy events, please email Training@PartnersBHM.org.
Permanent Supportive Housing (PSH) Training
Date, Time and Location: January 21 and 22, 2020, 8 a.m.-5 p.m., Hickory (Registration)
Description: This training will focus on the evidence-based model for Permanent Supportive Housing (PSH). This training will support Community Support Team providers by improving their understanding and practice of the PSH model.
Target Audience: Community Support Team providers
Provider Open House
Date, Time and Location: Thursday, February 6, 2020, 9:00 a.m. – 12:00 a.m., Gastonia (Registration)
Description: Join Partners’ Provider Network, Claims, Access to Care, Utilization Management, Care Management and Quality Management staff for an interactive information session. This open-house style event will allow each attended tome to work one-on-one with Partners’ staff to discuss any issues, questions, or unfamiliar topics. Participants are encouraged to bring their own laptops to access their specific workflow.
These sessions will not have a formal presentation or start time but is the providers’ time to meet one-on-one with Partners staff for technical assistance. As a registered attendee, you are welcome to arrive and exit at your convenience, depending on the amount of time you feel is needed with our staff. The intended audience for the open house includes established and new providers to the Partners’ network. Providers who are new in the Partners’ network are advised to already have established access to AlphaMCS and reviewed the provider orientation toolkit prior to attending a session.
Target Audience: Existing and New Providers in Partners Network.
Child & Family Team Training Part 1—An Introduction to Child & Family Teams: A Cross-System Training from the Family’s Perspective
Date, Time and Location: Thursday, January 9 and Friday, January 10, 2020, 9 a.m.-5 p.m. (both days) (Registration)
Catawba County Life Skills Facility, 3060 11th Avenue Drive SE, Hickory, NC 28602
Description: CFT 1 is a two-day experiential training (when you register, you are agreeing to attend both days) with the goal of providing an overview of Child & Family Team meetings from the family’s perspective. The training seeks to reinforce the idea of “one family, one plan” by addressing Child & Family Teams through the lens of multiple systems. Participants must attend both days in entirety to receive training credit.
Trainers: Kim Rhoads, MA, LCAS, Community Training Coordinator, Rhonda Baylor, Family Partner
Register by Friday, January 3, 2020
Child & Family Team Training Part 1—An Introduction to Child & Family Teams: A Cross-System Training from the Family’s Perspective
Date, Time and Location: Wednesday, January 15 and Thursday, January 16, 2020; 9 a.m.-5 p.m. (both days) (Registration)
Partners Gastonia Auditorium, 901 S New Hope Road, Gastonia, NC 28054
Description: CFT 1 is a two-day experiential training (when you register, you are agreeing to attend both days) with the goal of providing an overview of Child & Family Team meetings from the family’s perspective. The training seeks to reinforce the idea of “one family, one plan” by addressing Child & Family Teams through the lens of multiple systems.
Trainers: Jeanne Patterson, Community Training Coordinator, Casey Pruitt, Lead Family Contact – SAMHSA Grant. Please register by Thursday, January 9, 2020
Provider Alerts are sent to all providers who subscribed to receive Partners Provider Communications. Published alerts are available on the Provider Knowledge Base at https://providers.partnersbhm.org/provider-alert-archive/. To subscribe to Partners’ various communications, please visit https://www.partnersbhm.org/subscribe/.
Alerts issued since the last Provider Bulletin:
November 25, 2019 – Provider Operations Manual, Revised Manual SAR Form, CST Benefit Limits
December 6, 2019 – Claims Department Fax Number is Out of Service
December 10, 2019 – AlphaMCS Downtime; CST Training
December 12, 2019 – Claims Department Fax; DHB Tailored Plan; ComplexMHIDD-NC
Training, Announcements and Reminders
December Provider Webinar: Thanks to all providers who joined us for our quarterly Provider Webinar on Tuesday, December 10, 2019. Information regarding the webinar can be found at https://providers.partnersbhm.org/provider-webinars-forums/.
The next Quarterly Provider Webinar will be held on Wednesday, March 11, 2020 beginning at 1 p.m. – Register for the Quarterly Provider Webinar
Connect Burke: The next Connect Burke resource forum will be held on Tuesday, January 14 beginning at 8 a.m. at the Collett Street Recreation Center, 300 Collett Street, Morganton, NC 28655. This forum will focus on housing and homelessness issues and include numerous agencies that offer services, programs, and ways to connect to those you serve. Click here to register. To learn more, contact Jamie Piercy at firstname.lastname@example.org.
Recovery Coach Academy: The Recovery Coach Academy is a 30-hour training on the Recovery Coach model. It is approved for continuing education credits by NCSAPPB and the CPSS board and is open to people in long-term recovery. The training will be held Monday, January 27 through Friday, January 31 at Surry Community College, 1461 North Bridge Street, Elkin, NC. Registration is required. To learn more about Recovery Coach Academy or to register, please contact Elisa Bryant at 336-526-1918 or email email@example.com. This training is possible through a grant from Recovery Communities of NC (funded by NC DHHS and SAMHSA).
NAMI NC Helpline: The NAMI NC Helpline is open for families and individuals affected by mental illness. The Helpline is free and confidential and provides information, referrals and support. The Helpline operates Monday through Friday from 8:30 a.m.-5 p.m.
- Phone: 1-800-451-9682
- Text: 919-999-6527