Partners Launches COVID-19 Provider-Specific Webpage
Partners values the strong working relationship we have with our Network Providers. We have developed a webpage, https://providers.partnersbhm.org/covid-19/, where you will find the most up-to-date information in regard to COVID-19 and its impact on the members we serve.
Care Plan Signature Requirements: Partners recognizes the challenges providers are experiencing in obtaining signatures from members for clinical documents. At this time, in recognition of the realities of current pandemic situation and based on guidance from the NC Department of Health and Human Services (NC DHHS) and the U.S. HHS Office for Civil Rights, Partners will accept a qualified professional/ paraprofessional or clinician signature in place of the member or legally responsible person’s (LRP) signature, along with a notation that the member/LRP gave consent for the provider representative to sign the document on his or her behalf. These signatures can be electronic, within your Electronic Health Record systems.
The provider should document whether such consent was made via telephonic, email or other means (e.g. through a window). Any provider relying upon email consent should follow up via telephone communication with the member/LRP to secure verbal consent if possible.
To verify you are speaking with the member/LRP, the best practice is to ask for another identifier (besides name and date of birth), such as a Social Security number or Medicaid number. Always try to obtain express consent for disclosure of any substance use information. Member/LRP consent or approval should be clearly documented in the service note.
Monitoring Site Visits: Partners has made the decision to suspend all routine monitoring, including virtual, for the next 30 days. We will reassess as conditions are changing daily. This includes unlicensed Alternative Family Living, post payment reviews and sites visits for credentialing (initial and recredentialing). Partners will offer the provider the opportunity to virtually complete any reviews that the Partners Quality Management (QM) Monitoring department currently has in process. If the provider cannot complete the review at this time, providers will be offered the opportunity to reschedule.
Authorizations: Effective March 19, 2020, Partners is lifting the requirement to obtain prior authorization for member services until April 30, 2020. Providers can continue to deliver and bill for services.
- The number of units that were approved in the most recent authorization will stay the same.
- Medical Necessity will still apply.
- Upon the first concurrent authorization after this period, all documentation must be submitted to Utilization Management according to the Service Definition and additional guidance from NC DHHS.
New Service Codes – USE CR Modifier: Effective March 13, 2020, NC Medicaid, NC DHHS and Partners will offer reimbursement for telephonic evaluation and management for established members.
Below are the rates for the COVID 19 codes and the information from NC Tracks. The codes are being added to provider contracts with an effective date of March 13, 2020. Providers can start using the codes with the effective date of March 13, 2020. The contract amendment will be sent as quickly as it can be processed. These codes were automatically added to providers contracts for those providers who deliver outpatient services as part of their continuum. Providers should review the information below and, if you provide a service where these codes could be utilized, please email PNAS@partnersbhm.org to request these codes be added to your contract.
Codes for Psychiatrists, Clinical Psychologists, Nurse Practitioners, Physician Assistants
- 99441CR: Telephone evaluation and management service by a physician or other qualified health care professional who may report evaluation and management (E/M) services provided to an established patient, parent or guardian not originating from a related E/M service provided within the previous seven days or leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
- 99442CR: Telephone evaluation and management service by a physician or other qualified health care professional who may report E/M services provided to an established patient, parent or guardian not originating from a related E/M service provided within the previous seven days or leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion.
- 99443CR: Telephone evaluation and management service by a physician or other qualified health care professional who may report E/M services provided to an established patient, parent or guardian not originating from a related E/M service provided within the previous seven days or leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion.
Codes to be used when reporting behavioral health telephonic assessment and management by a licensed non-physician behavioral health professional (licensed clinical social worker (LCSW): licensed clinical social worker associate (LCSW-A); licensed professional counselor (LPC); licensed professional counselor associate (LPC-A); licensed marriage and family therapist (LMFT); licensed marriage and family therapist associate (LMFT-A); licensed clinical addiction specialist (LCAS); licensed clinical addiction specialist associate (LCAS-A); psychologist and licensed psychological associate (LPA):
- 98966CR: Telephone assessment and management service provided by a qualified non-physician health care professional to an established patient, parent or guardian not originating from a related assessment and management service provided within the previous seven days not leading to an assessment and management service or procedure with the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion.
- 98967CR: Telephone assessment and management service provided by a qualified non-physician health care professional to an established patient, parent or guardian not originating from a related assessment and management service provided within the previous seven days not leading to an assessment and management service or procedure with the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion.
- 98968CR: Telephone assessment and management service provided by a qualified non-physician health care professional to an established patient, parent or guardian not originating from a related assessment and management service provided within the previous seven days not leading to an assessment and management service or procedure with the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion.
ICD-10 Diagnosis Codes
ICD-10 diagnosis codes to report Coronavirus Virtual Patient Communication and Telephonic Evaluation and Management codes include:
- If the visit is for COVID-19 symptoms, contact with and (suspected) exposure to other viral communicable disease: Z20.828
It is important to note that the CR codes can be used to bill individual therapy sessions for members authorized for other services if those delivering the service meet the criteria. For example, licensed clinicians that serve on an intensive in-home team, may use these codes and the CR modifier to provide this service to those members but not on the same day when billing another service.
The interpretation for the term “established client” for use of the CR codes is for those members who have had an intake and assessment completed.
COVID-19 Special Medicaid Bulletins: Providers are reminded to visit www.ncdhhs.gov/coronavirus for the latest information from the North Carolina Department of Health and Human Services.
NC Medicaid has issued seven Special Medicaid Bulletins related to COVID-19 since March 10, 2020. You can access all Medicaid Bulletins at https://medicaid.ncdhhs.gov/providers/medicaid-bulletin.
Joint Communication Bulletins, which are issued by the NC Department of Health and Human Services, can be found at https://www.ncdhhs.gov/divisions/mhddsas/joint-communication-bulletins.
Recent Joint Communication Bulletins:
- #J357 Department of Health and Human Services COVID-19 Service Guidance and NC Innovations Waiver Guidance
- #J356 LME-MCO Certification Data Validation Process
NC Medicaid Requests Temporary Plan Changes to Respond to COVID-19: The following press release was issued by NC DHHS on March 18, 2020:
The North Carolina Department of Health and Human Services has sought authority from the Centers for Medicare & Medicaid Services to temporarily waive certain Medicaid and NC Health Choice policies as part of North Carolina’s response to the COVID-19. The waivers will provide flexibility to NC Medicaid and providers to address the urgent health care needs of beneficiaries during this public health emergency.
NC Medicaid will use the authority, once granted, to streamline NC Medicaid provider enrollment; waive facility access and length of stay limits, which would allow for example critical access hospitals to have more beds and for patients to stay longer; and allow alternative settings to deliver care such as providing services in home. NC Medicaid requested these flexibilities from CMS on March 17, 2020.
Additionally, NC Medicaid is requesting temporary modifications to home- and community-based services provided through Medicaid state plan waivers, including the Innovations, Community Alternatives for Disabled Adults, Community Alternatives for Children and Traumatic Brain Injury waivers. These requests include removing certain dollar and stay limits, expanding the type of location where services can be delivered and easing requirements for reviews of personalized care plans and in-person meetings. Temporary modifications to waiver services and requirements will be made on an individual basis. NC Medicaid requested these waiver flexibilities on March 13, 2020.
NC Medicaid will share additional details following CMS review and determination. All NC Medicaid requested flexibilities documents, along with other Medicaid-related COVID-19 information, can be viewed at www.medicaid.ncdhhs.gov/coronavirus. For general COVID-19 information and resources, visit www.ncdhhs.gov/coronavirus.
NC Updates on COVID-19: Providers are asked to check the NC DHHS NC Updates on COVID-19 webpage (https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-response-north-carolina/nc-updates) daily for items of interest to providers.
Partners 2020 Needs Assessment and Gaps Analysis Survey
Partners continues to conduct its annual Needs Assessment and Services Gaps Analysis to understand the behavioral health needs of the citizens in the regions we serve.
We ask providers to direct their members to the survey at https://www.partnersbhm.org/community-needs-assessment-survey/. The survey is open through March 31, 2020. We sincerely appreciate your help in this process, and we look forward to hearing from you!
March Provider Council Meeting
Partners’ Provider Council will meet via teleconference on March 27, 2020. Providers will meet from 9:30 a.m.–10:30 a.m. Partners’ employees will join the meeting at 10:30 a.m. If you have questions or would like to learn more about the Provider Council, visit https://providers.partnersbhm.org/provider-council/.
- To access the meeting from your computer, tablet or smartphone: https://global.gotomeeting.com/join/489957229
- You can also dial in using your phone: 1 872-240-3412, Access Code: 489-957-229
- New to GoToMeeting? Get the app now and be ready when your first meeting starts: https://global.gotomeeting.com/install/489957229
Provider Operations Manual
Partners has updated its Provider Operations Manual, located at https://providers.partnersbhm.org/orientation-packet-provider-operations-manual/. This manual outlines the requirements and responsibilities of those in Partners’ Provider Network. All providers should review and be familiar with this manual.
March Quarterly Provider Webinar
Partners hosted its Quarterly Provider Webinar on Wednesday, March 11, 2020. Information from the webinar is available at https://providers.partnersbhm.org/provider-webinars-forums/.
Licensed Independent Practitioner Collaborative—May 13, 2020
Partners developed the Licensed Independent Practitioner (LIP) collaborative to improve communication with the Licensed Independent Practitioners. Meetings are held quarterly via conference call or webinar. The next webinar will be held on May 13, 2020 beginning at noon. Click here to register. If you have questions, please contact firstname.lastname@example.org.
Attention I/DD Providers: NC-SNAP
The NC Supports Needs Assessment Profile, commonly referred to as NC-SNAP, is required for ALL individuals with Intellectual and/or Developmental Disabilities receiving services funded by State funds, B3, Intermediate Care Facilities for Individuals with Intellectual Disability (ICF-IID), or state developmental centers who have not have a Supports Intensity Scale (SIS) Assessment completed.
Completion of the NC-SNAP is the responsibility of the organizations providing intellectual/developmental disabilities (I/DD) services. Partners does not have the ability to complete NC-SNAPs on behalf of provider agencies. Agencies should have a certified NC-SNAP Examiner on staff. If your agency does not have a certified NC-SNAP Examiner on staff, Partners encourages you to work with other agencies to get NC-SNAPs updated annually as required.
NC-SNAP trainings are held monthly on the Dorothea Dix campus in Raleigh via DMH/DD/SAS. The training is available to I/DD professionals responsible for completing or reviewing NC-SNAP assessments as part of their job responsibilities. The NC DHHS MH/DD/SAS website, https://www.ncdhhs.gov/providers/provider-info/mental-health/nc-support-needs-assessment-profile, includes information about NC-SNAP registration procedures and training schedules.
- All persons, except Developmental Center staff, are required to register through the area LME/MCO Training Coordinator. Developmental Center staff should register through your Developmental Center Training Coordinator.
- Training is provided free of charge and only to those referred by the LME/MCO or Developmental Centers. All persons referred for NC-SNAP training should have been assigned responsibility for the NC-SNAP by the LME/MCO, Developmental Center, or private provider.
- The NCDHHS NC-SNAP point of contact and lead instructor is Rachel Noell, email@example.com, 919-715-1294
- Partners’ Training Coordinator is Michelle Stroebel, Training@PartnersBHM.org
- An NC-SNAP is valid for one year. Authorization periods must be covered by a valid NC-SNAP. A gap in NC-SNAP coverage dates could result in recoupment of claims.
- A NC-SNAP update must be completed if the consumer is transferred to another I/DD service provider, is discharged, or will no longer receive any I/DD services (including transitioning to non-I/DD services). An update is done by completing the NC-SNAP Summary Report & Supplemental Information form (cover sheet), marking the change in I/DD Support Status and indicating the changes on the form.
- All completed NC-SNAPs and updates must be faxed to 704-884-2690, and sent to the attention of Laura Reisinger and Roxann Revels, or they may be emailed to firstname.lastname@example.org. These are entered into the North Carolina NC-SNAP Database.
- All completed NC-SNAPs (all pages) and updates must also be uploaded into AlphaMCS.
If you have questions, you may contact Laura Reisinger by email at email@example.com, by phone at 704-884-2645 or by fax to 704-884-2690.
Providers are reminded to use the email firstname.lastname@example.org for all email inquiries so that 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 does request copies of the Explanation of Benefits (EOB) for members/claims submitted indicating Coordination of Benefits. The request will originate via email from Partners’ Claims Department. Once requested, please submit the information, via secured email, prior to the date indicated in the emailed request. If a response is not received, the original claim payment will be recouped.
|February 2020: Medicaid—Number of Days to Process and Pay All Claims|
|Received Date to Paid Date:||9.0|
Top Five Medicaid Claim Denials for February 2020
Provider Recommended Action Steps
|Service is not authorized||Verify Service Authorization for the member. Contact Utilization Management.|
|Invalid DCN (Document Clrl#) or resubmission ref #||Look at the Remittance Advice with the original claim number and make sure you entered it correctly.|
|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.
|Invalid Units: units claimed does not equal # of days for Discharge Claim.||
Review the units billed and the date range. Rebill with corrections.
Partners Training Academy
Providers should check the Partners Event Calendar, https://www.partnersbhm.org/event-calendar/, frequently for the most up-to-date information. We will strive to make decisions about in person trainings one week in advance of the scheduled date. If you are registered for an event or training that is canceled, you will receive an email notification.
All Partners Training Academy sessions are free to registered attendees. Register in advance at www.PartnersTraining.org. If you have any questions about Partners Training Academy events, please email Training@PartnersBHM.org.
Community Support Team – Permanent Supportive Housing (PSH) (Register)
Date, Time, Location: April 6 -7, 2020, 8 a.m.- 5 p.m. (one-hour lunch on your own), Hickory Multipurpose Room
Description: In preparation for the implementation of the new Community Support Team (CST) policy, we have scheduled a series of two-day trainings on the evidence-based model for Permanent Supportive Housing (PSH). With the policy change, CST providers are to provide ongoing, tenancy support services. This training will support CST providers by improving their understanding and practice of the PSH model. Experienced and certified PSH trainers from the Technical Assistance Collaborative (TAC) created the training content.
Target Audience: Providers working with members with housing needs.
Trainers: Michelle Stroebel, MA, NCC, LPCA and Carolyn Shoaf, LRT
Ethics in a Managed Care Environment (Register)
Date, Time, Location: April 28, 2020, 9 a.m.-4:30 p.m. with lunch on your own. Gastonia Auditorium
Description: Please join us for an Ethics training. All providers are invited. CEU’s are pending per application to NBCC for approval of six credit hours. Individuals can not miss more than 15 minutes and gain CEU credit.
Target Audience: Network Providers
PCP Instructional Elements Training (Register)
Date, Time, Location: April 29, 2020, 1 p.m.-4 p.m., Hickory Multipurpose Room
Description: This course will meet the requirement for 3 hours of training for PCP Instructional Elements. Training content will include documentation requirements for both Person Centered Plans (PCP’s) and Crisis Plans. All providers are invited, especially those that write PCP’s and Crisis Plans. Each attendee must individually pre-register as this course is limited to 40 participants.
Target Audience: Providers
Trainer: Partners’ Utilization Management Department
Re-envisioning Care for People with Involved Disabilities (Register)
Date, Time, Location: Ongoing Online Training
Description: The Center for Consumer Engagement in Health Innovation has launched a new video series to help clinicians and health system leaders understand and adopt principles of person-centered care. The videos examine how the values of the independent living model can help to create a system of care that lowers barriers to care and honors the lived experience of people with disabilities; explore how changes to organizational culture can reflect a holistic, person-centered system of care; and highlights how home-based primary care can improve the support of people with complex health and social needs.
Target Audience: Providers
Supervising NC Certified Peer Support Specialists (Register)
Date, Time, Location: Ongoing Online Training
Description: This course is designed to introduce participants to the identified supervisory competencies and to enhance their understanding of the central principles of Peer Support. Participants are asked to evaluate their own systems of service and to apply course concepts to the implementation of Peer Support Services within their organizations. This course has been approved for three hours of General Skills Building credit from the North Carolina Substance Abuse Professional Practice Board. Approval #16-228-H-S Contact Hours: 3.00
Continuing Education: NCCPSS and NCSAPPB.
Target Audience: Providers working with members with housing needs.
Trainer: Online, through Behavioral Health Springboard.
Additional Training Resources:
Developing Therapeutic Conversations That Facilitate Client Change: Introduction to Motivational Interviewing, Charlotte, NC
Date, Time, Location: April 6–7, 2020
Description: Motivational Interviewing (MI) is an evidence-based treatment that addresses ambivalence to change. MI is a conversational approach designed to help people with the following:
- Discover their own interest in considering and/or making a change in their life (e.g., diet, exercise, managing symptoms of physical or mental illness, reducing and eliminating the use of alcohol, tobacco, and other drugs)
- Express in their own words their desire for change (i.e., “change-talk”)
- Examine their ambivalence about the change
- Plan for and begin the process of change
- Elicit and strengthen change-talk
- Enhance their confidence in taking action and noticing that even small, incremental changes are important
- Strengthen their commitment to change
This training meets State requirements for MI training by a MINT certified trainer. Participants receive 13 NC Board NCASPPB & NASW approved continuing education hours and lunch.
Trainer: Laurie Conaty.
Registration: Email Laurie Conaty, email@example.com, for pricing information (discounts for multiple registrants)
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:
March 16, 2020 – Follow up to March 16, 2020 Provider Teleconference #1 | Temporary Service Disruption Form | Communication to Groups from Kody Kinsley
March 13, 2020 – Provider Teleconference | Medicaid Special Bulletin
March 12, 2020 – NC Medicaid Updates
March 11, 2020 – DMH/DD/SAS Webinar | Special Medicaid Bulletin
March 10, 2020 – NC DHHS COVID-19 Information
March 4, 2020 – 2020 Partners Community Network Adequacy and Accessibility Analysis Survey
March 2, 2020 – Coordination of Care Assessment Survey | Update to 01/31/2020 Alert – State-funded CST
February 28, 2020 – NC Council for Women/Domestic Violence Commission Access to Healthcare Survey
February 26, 2020 – Retro SARs; ASWOM Benefit Plan; Town Halls; Learning Community
Training, Announcements and Reminders
The following events are being held by various organizations. Please check with the organization regarding registration and cancellation information.
Brain Injury Association of North Carolina 2020 Family Conference: The Brain Injury Association of North Carolina will host its 2020 Family Conference “Life After Brain Injury—Journey Toward Wellness” on April 26-27, 2020 at Great Wolf Lodge Conference Center in Concord, NC. Visit www.biancfamilycon2020.com for registration and more information. Exhibitor opportunities are also available.
Women’s Recovery Conference: Mountain AHEC is hosting a Women’s Recovery Conference “Raising Resilience through Authenticity” May 6-8, 2020 at Mountain AHEC, Asheville NC. Visit https://mahec.net/event/61047 to learn more and to register.
NC TIDE Spring Conference: NC TIDE has been rescheduled to June 28-July 1, 2020. All previous hotel reservations have been updated. If you have an address on file with Hotel Ballast you should be receiving a new confirmation. To learn more, visit http://nctide.org/.
Navigating the Path to Emotional Wellness: The Gastonia Parish Nurse Ministry will host “Navigating the Path to Emotional Wellness”, an informative seminar on mental health and emotional wellness. The day-long event will be held on May 13, 2020 at First Presbyterian Church, Gastonia, NC. Visit www.fpcgastonia.org/emotionalwellness to learn more.
Surry Friends of Youth STEP Class: Systematic Training for Effective Parenting (STEP) is a seven-week program for parents and guardians of teenagers. It focuses on building better communication and support for the entire family.
Adolescence often presents an assortment of issues for parents, and this class aims to provide guidance in addressing some of those issues. This class uses methods from the STEP program to help develop problem solving skills, sort through proper discipline methods and increase positive communication between you and your teen.
The seven-week program will begin on Monday, April 6, 2020 and run through May 18, 2020. Classes will be held at Surry Friends of Youth, 1151 West Lebanon St., Mount Airy, NC 27030. To learn more, call 336-789-9064 or email firstname.lastname@example.org.