Partners Provider Council

The Partners Provider Council will meet virtually this Friday, May 22, 2020. Both providers and Partners’ Provider Network staff will join the meeting at 9:30 a.m. Click here to register.

June Quarterly Provider Webinar

Partners hosts a quarterly Provider Webinar to communicate important information and detailed updates to our providers about a variety of topics. The next Quarterly Provider Webinar will be held June 10, 2020 beginning at 1 p.m. Click here to register. To view past webinars, please check out our Provider Webinar Archive.

State News/COVID-19 Updates

Providers are reminded to check Partners’ COVID-19 provider webpage for the most up-to-date information regarding the pandemic and service delivery. If you have questions, please email your provider account specialist or the Provider Network Help Desk at pnas@partnersbhm.org.

Partners List of Applicable Rules and Regulations: Partners has updated its Applicable Laws and Regulations for Regulatory Compliance webpage to capture regulations regarding COVID-19. View the list at https://providers.partnersbhm.org/compliance-laws-regulations/.

Medicaid Special Bulletins can be located at https://medicaid.ncdhhs.gov/providers/medicaid-bulletin. Partners is listing bulletins relevant to behavioral health and intellectuals and developmental disabilities on its COVID-19 provider webpage.

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:

ADA and Rehabilitation Act: As a reminder, federal law requires all Medicaid providers in North Carolina to comply with the Americans with Disabilities Act (ADA) and Rehabilitation Act, which includes providing reasonable accommodations for people living with disabilities. Two publications provide information and guidance regarding individual rights and visitors in health care settings:

  • “Civil Rights, HIPAA, and the Coronavirus Disease 2019 (COVID-19)”  (https://www.hhs.gov/sites/default/files/ocr-bulletin-3-28-20.pdf) released in March by U.S. Department of Health and Human Services Office of Civil Rights (OCR). The objective by OCR is to ensure that entities covered by civil rights authorities keep in mind their obligations under laws and regulations that prohibit discrimination based on race, color, national origin, disability, age, sex, and exercise of conscience and religion in HHS-funded programs.
  • Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings” released in April, providing U.S. Centers for Disease Control (CDC) guidance regarding allowing visitors who are essential for the patient’s physical or emotional well-being and care. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html.

For individuals with cognitive impairment or intellectual disability, it is important to ensure the individual has adequate support for decision-making and treatment. These individuals may need to have a caregiver accompany them in either the ambulance or in the hospital. Accompaniment should be allowed per the guidance above. For more information, please refer to “SPECIAL BULLETIN COVID-19 #83: Title II Americans with Disabilities Act (ADA) and Section 504 Rehabilitation Act (RA) Protections during the COVID-19 Pandemic” on the NC Medicaid website.

NC DHHS Launches Interactive COVID-19 Dashboard: On May 20, 2020, The North Carolina Department of Health and Human Services unveiled an updated COVID-19 Dashboard. The interactive dashboard provides an overview on the metrics and capacities that the state is following to inform decisions to responsibly ease measures that slow the spread of the virus. Read more

Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call For BH/IDD Consumers, Family Members and Community Stakeholders:
Every Monday at 2:00 p.m. Toll-Free: 844-291-5495| Access Code: 1279313

Joint DMHDDSAS and DHB (NC Medicaid) COVID-19 Update Call For NC Providers:
Every Thursday at 3:00 p.m.
May 21 Participant Log-In Information: https://register.gotowebinar.com/register/5826920552509697296

After registering, you will receive a confirmation email containing information about joining the webinar.

Closed Captioning Services:  At the start time of the event, please login to your event by clicking here: https://www.captionedtext.com/client/event.aspx?EventID=4446090&CustomerID=324

Interest Requested: Care Management Agency/Advanced Medical Home Plus

Partners wants to hear from organizations who are interested in applying to be a Care Management Agency or Advanced Medical Home Plus. Please complete the following survey by Friday, June 12, 2020: https://www.surveymonkey.com/r/6LFP7HK

Claims Information

Providers are reminded to use the email claimsdepartment@partnersbhm.org for all email inquiries so that they are handled in the most efficient manner. Please do not send email directly to individual employees. 

AlphaMCS Portal University is an available resource and guide for navigating AlphaMCS. If you need additional claims training, email rcolvard@partnersbhm.org to schedule a time for training.

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.

April 2020: Medicaid—Number of Days to Process and Pay All Claims
Received Date to Paid Date: 8.9

Top Five Medicaid Claim Denials for April 2020

Claim Denial

Provider Recommended Action Steps

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.
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.
Client has other covered insurance. Ensure primary insurance for the member has been billed and is indicated in the claim submitted to the MCO.
Invalid Service or Service Discontinued

 

Service has been lapsed/removed from the benefit plan and is no longer billable or does not exist in the system.

Partners Offers Online Classes for Members

Due to the challenges created by the COVID-19 crisis of having in-person trainings, Partners Behavioral Health Management is joining with WellSurgent to offer online classes for members and community stakeholders who are interested in behavioral and mental health, stress management, substance use disorder recovery and treatment, and other life challenges.

Specific courses offered as part of this collaboration include: Feel, Deal and Heal; S.M.A.R.T. Recovery®; WHAM (class is currently full); and Wellness 101. More information on the courses and sample topics can be found below.

Feel, Deal and Heal

courses cover a wide variety of stress management tools and wellness strategies. The class will help participants identify stressors and create an action plan to deal with those stressors. Each class will have a different topic. The following sessions are currently being offered:

  • May 21, 2020, 6:30 p.m. – Your Story…Is It a Wellness Story or an Illness Story
  • May 26, 2020, Noon – STOP…Love and Live
  • June 2, 2020, Noon – Remembering Who You Are
  • June 9, 2020, Noon – How to Build Resiliency: Mentally, Physically, Emotionally and Socially
  • June 16, 2020, Noon – Spirituality: Avoiding Shame and Guilt
  • June 23, 2020, Noon – HOPE: Empowerment, Personal Responsibility, Advocacy & Support from Others
  • June 30, 2020, Noon – Five Hindrances That Keep Us from Being Our Best Self

Register at https://www.partnersbhm.org/events/feel-deal-and-heal/  –  View the flyer

SMART© Recovery Group (Self-Management and Recovery Training)

SMART© Recovery Group is a global community of mutual support groups. At meetings, participants help one another resolve problems with addiction, whether it be drugs, alcohol, gambling or over-eating. Participants find and develop the power within themselves to change and lead fulfilling and balanced lives. Because participants will have the opportunity to engage with each other, no two SMART meetings are exactly alike.
Register at https://www.partnersbhm.org/events/self-management-and-recovery-training/  –  View the flyer

Wellness 101

Wellness 101 identifies the potential benefits that motivate a peer to act. Feeling better must become a lifestyle and identifying how you are feeling every day ensures the possibility of living well for longer periods. The following sessions are being offered beginning May 28, 2020:

  • May 28, 2020, 6:30 p.m. – Personal Development
  • June 4, 2020, 6:30 p.m. – Daily Maintenance Planning & Recovery Pathways
  • June 11, 2020, 6:30 p.m. – Acupressure Points to Relieve Stress and Pain and the Five-Second Rule by Mel Robbins
  • June 18, 2020, 6:30 p.m. – What Are Your Gifts?
  • June 25, 2020, 6:30 p.m. – Boredom, Burnout and Fatigue

Register at https://www.partnersbhm.org/events/wellness-101/  –  View the flyer

Partners Training Academy

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.

Considerations for Technology-Based/Telehealth Services (Register)

This training is being offered by Complex Systems Innovations, LLC for Partners network providers. This is a four-part online series beginning May 26, 2020. Providers should sign up for each course individually at https://www.complexsystemsinnovations.com/pbhm/.

Dates, Times, Location:  Sessions are from 12:00 p.m.- 1:00 p.m. Each session allows log-in from 11:45 a.m.-12:00 p.m. May 26, 2020, Ethical and Policy Considerations for Technology-Based Services

  • May 27, 2020, Best Practices within Telehealth Service Environments
  • June 9, 2020, Practice Administration and Accreditation During and After a Pandemic
  • June 11, 2020, Formulating a Post-Pandemic Service Delivery Strategy

Description: This four-part training series will introduce clinicians and other behavioral health professionals to key considerations in the delivery of technology-based/telehealth services. North Carolina policy and ethical standards will be reviewed and recommendations for best practice will be shared. Accreditation strategies will be reviewed, and participants will gain an understanding of the complexities related to COVID-19 and post-pandemic service delivery integration.

Content Objectives:

  1. Examine technology-based service delivery systems that meet ethical and policy standards of North Carolina.
  2. Identify which behavioral health best practices can be most adaptable in a telehealth service environment.
  3. Analyze strategies for quality assurance and accreditation conformance in a pandemic environment.
  4. Evaluate the impact of COVID-19 on current behavioral health service delivery methods and identify resources to assist clients seeking alternative care solutions post-pandemic.

Providers can participate in any number of sessions.  Those who fully participate in all four sessions with both audio and visual communication can gain CE credit from ASWB after completing a survey.

Target Audience: Providers and Agency leaders

Trainer: Dr. Gary Walby, Complex Systems Innovations, LLC

Trauma Informed Care – Seeking Safety (Register)

Date, Time, Location: May 26 and May 28, 2020, 9:30 a.m.-12:45 p.m.

Description:  Trauma plays a major role in why people get stuck and use problematic coping strategies. Understand trauma, PTSD, and the treatment of substance use disorders better with Seeking Safety.

NCSAPPB approved for up to six hours 19-558-S. You will be emailed a training link after registering. There will be two three-hour sessions, you must attend both sessions and participate both with audio and visual capabilities to receive credit. No partial credit will be given.

Target Audience: Providers

Trainer: Eric Ottinger, Recover Rebel Recovery LLC

Harm Reduction 101 (Register)

Date, Time, Location: May 29, 2020 10 a.m.-12 p.m., Online

Description: This course includes an introduction to harm reduction as a philosophy specifically focused on working with individuals with substance use disorder. Topics covered include:

  • Harm Reduction terminology
  • Fentanyl myths
  • Naloxone
  • Overdose prevention and reversal
  • Recognizing stigmatizing language as a barrier to care
  • Ways to get involved in harm reduction at multiple levels

Target Audience: Providers

Trainer: Michelle Mathis, Olive Branch Ministries

Ethics in a Managed Care Environment (Register)

Date, Time, Location: June 1, 2020, 9 a.m.-4:30 p.m., Online

Description: This course reviews current ethical standards in service delivery, such as:

  • How one’s morals and values affect ethics
  • How policies and procedures may affect ethics
  • How to manage dilemmas one may face while in practice
  • Identify steps to resolve ethical dilemmas

CEUs are pending from NBCC for approval. This training will utilize Zoom. Registrants will receive the zoom registration the week before the training. Registrants must continuously use both video and audio for the full training to gain CEU credit.

Target Audience: Providers

Trainer: Barbara Hallisey, Director of Recovery Solutions and Jeffrey Sanders, MH/SU Transition to Community Living Program Manager

NCTOPPS Discussion Webinar (Register)

Date, Time, Location: June 3, 2020, 2 p.m.-2:30 p.m.

Description: The purpose of the monthly NC-TOPPS Discussion Webinar is to provide a space for the attendees to receive updates, ask questions and provide feedback to the Partners NC-TOPPS superuser as well as other superusers.  Both new and existing users are welcome,

Target Audience: Providers who use NC-TOPPS

Trainer: Veronica Somerville, QM Analyst

Illness Recovery Management (Register)

Date, Time, Location: June 2 and June 4, 2020, 9:30 a.m.-12:45 p.m., Online

Description: Illness Management and Recovery (IMR) is an evidenced-based practice designed to provide mental health consumers with the knowledge and skills necessary to cope with aspects of their mental illness while maintaining and achieving goals in their recovery. Learn more about understanding and treating Depression, Bipolar Disorder and Psychotic Disorders that occur either with or without substance use.

NCSAPPB approval code 20-059-S. You will be emailed a training link after registering. There will be two three-hour sessions, you must attend both sessions and participate both with audio and visual capabilities to receive credit. No partial credit will be given.

Target Audience: Providers

Trainer: Eric Ottinger, Recover Rebel Recovery LLC

Virtual Provider Open House (Register)

Date, Time, Location: Thursday, June 4, 2020, 9:00 a.m.-11:00 a.m., Online

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. We will use Zoom and breakout rooms for this open house. 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 before attending a session.

Target Audience: Existing and New Providers in Partners Behavioral Health Management Network.

Quarterly Provider Forum Webinar (Register)

Date, Time, Location: June 10, 2020, 1 p.m.-3 p.m., Online

Description: Please join us for the Partners Quarterly Provider Forum Webinar.  Agenda items will provide updates and vital information for providers.  A recording of this webinar will be posted to the Partners training library for future viewing.

Target Audience: Providers

Trainer: Beth Lackey, Provider Network Director and other Partners leaders

Community Support Team Service Definition Training (Register)

Date, Time, Location: June 23, 2020, 8:30 a.m.-Noon, Online

Description: Community Support Team (CST) provides direct support to adults with a DSM-5 diagnosis of mental illness, substance use, or comorbid disorder and who have complex and extensive treatment needs. All members of the CST team are required to have 3 hours of service definition training.  This recorded webinar will meet this training requirement by reviewing all of the components of the new service definition. Participants will achieve an understanding of requirements and scope of the new definition.   Attendees must engage in the full three-hour training and pass a 10 question quiz to receive a training certificate. This webinar is a recorded event. Two breaks are included during the training. The training meets the requirement for CST team members to receive three hours of service definition training. Attendees must take a 10-question quiz and pass at a rate of 80% or higher in order to gain a training certificate.

Target Audience:  CST Providers

Trainer: Partners Utilization Management staff

NC-TOPPS Discussion Webinar (Register)

Date, Time, Location: July 1, 2020, 2 p.m.-2:30 p.m.

Description: The purpose of the monthly NC-TOPPS Discussion Webinar is to provide a space for the attendees to receive updates, ask questions and provide feedback to the Partners NC-TOPPS superuser as well as other superusers.  All are welcome, both new and existing users.

Target Audience: Providers who use NC-TOPPS

Trainer: Veronica Somerville, QM Analyst

Community Training

Trauma Informed Care (Register)

Date, Time, Location: May 29, 2020, 10 a.m.-11:30 a.m., Online

Description: Trauma is wide-spread and the impact on the people we serve is immense. This webinar will cover the scope of trauma and its effects on behavior. Learn how to respond to in a trauma-informed manner that will promote resilience and improve outcomes.

Target Audience: Community, Providers

Trainer:  Jeanne Patterson, SOC/Community Training Coordinator, Partners

Be sure to check the Partners Event Calendar for additional community training opportunities.

Other training resources and opportunities

Resource for ACT and IPS Trainings

The Institute for Best Practices, UNC Chapel Hill, www.institutebestpractices.org

Person Centered Thinking

Date, Time, Location: June 3-4, 2020, 8:30 a.m.-4 p.m., Online

Cost: $120

Description:  Hyman Consulting is offering PCT training in a virtual format. Participants will develop skills in person-centered thinking through a series of discussions, applied stories, and guided exercises.

Target Audience: Providers

Trainer: J. Bennett, PCT trainer with The Learning Community

Register at https://www.eventbrite.com/e/person-centered-thinking-virtual-training-pct-training-tickets-104966617980?aff=affiliate1

Improving Cultural Competency for Behavioral Health Professionals

Date, Time, Location: This training is a self-study from the Office of Minority Health website. FREE CEUs

Description: Cultural and linguistic competency is recognized as an important strategy for improving the quality of care provided to clients from diverse backgrounds. The goal of this e-learning program is to help behavioral health professionals increase their cultural and linguistic competency.

  • In Course 1, An introduction to cultural and linguistic competency, you’ll learn what culture has to do with behavioral health care.
  • In Course 2, Know thyself – Increasing self-awareness, you’ll learn how to get to know your cultural identity and how it affects your work with clients.
  • In Course 3, Knowing others – Increasing awareness of your client’s cultural identity, you’ll learn how to get to know your client’s cultural identity.
  • In Course 4, Culturally and linguistically appropriate interventions and services, you’ll learn how to build stronger therapeutic relationships with clients from diverse backgrounds

The estimated time to complete all four courses is between 4-5.5 hours.

Target Audience: This program is accredited for 4-5.5 contact hours for counselors, nurses, psychologists, psychiatrists, and social workers. Other professionals may earn a Statement of Participation.

Register at https://thinkculturalhealth.hhs.gov/education/behavioral-health

Provider Alerts

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/

Training, Announcements and Reminders

The following events are being held by various organizations. Please check with the organization hosting the event regarding registration and cancelation information.

I’m IN: Community Inclusion Webinar: People living with mental illness experience exclusion from the community. They even exclude themselves sometimes. For Community Inclusion to work, we must address our experiences of exclusion and reverse their effects If we work in the field, a deeper understating of exclusion and its reversal will increase our effectiveness in collaboration to create more inclusive communities. A free webinar will be held May 26, 2020 from 2 p.m.-3:30 p.m. To register for this event, click here. If you have questions, please email Michael Owen at michael@i2icenter.org.

Doors to Wellbeing Peer Specialist Monthly Webinar Series: Doors to Wellbeing is hosting a series of webinars and recordings for Peer Specialists. To learn more, visit https://www.doorstowellbeing.org/webinar-recordings.

Free Fair Housing Training Available: Providers, property management staff, landlords and others who help with housing are invited to attend free fair housing training facilitated by the NC Legal Aid Fair Housing Project.

Registration is now open at https://cvent.me/ZQPmXO. If you have difficulty with the registration link, please email Karen Williams at kmwilliams@nchfa.com. You will be sent the login information once you register and provide an email address.

Wednesday, May 27, 2020

  • Housing Providers: 10 a.m.-12 p.m.
  • Service Providers: 1 p.m.-3 p.m.

Wednesday, June 17, 2020

  • Housing Providers: 10 a.m.-12 p.m.
  • Service Providers: 1 p.m.-3 p.m.

Wednesday, June 3, 2020

  • Housing Providers: 10 a.m.-12 p.m.
  • Service Providers: 1 p.m.-3 p.m.

Wednesday, June 24, 2020

  • Housing Providers: 10 a.m.-12 p.m.
  • Service Providers: 1 p.m.-3 p.m.

Wednesday, June 10, 2020

  • Housing Providers: 10 a.m.-12 p.m.
  • Service Providers: 1 p.m.-3 p.m.

Operation Fan Heat Relief to Begin Distributing Fans to Eligible Recipients May 1: As the weather starts warming up, the North Carolina Division of Aging and Adult Services is partnering with the NC Area Agencies on Aging and local service providers to distribute fans to eligible recipients through Operation Fan Heat Relief May 1–Oct. 31.

People 60 and older, as well as adults with disabilities, are eligible to sign up for assistance from May 1–Oct. 31 at local aging agencies across the state. Since 1986, the relief program has purchased fans for older adults and adults with disabilities, providing them with a more comfortable living environment and reducing heat-related illnesses.

As individuals age and develop chronic medical conditions, they are less likely to sense and respond to changes in temperature. They may also be taking medications that can worsen the impact of extreme heat. Operation Fan Heat Relief helps vulnerable adults at risk for heat-related illnesses stay safe during the summer.

In addition to applying for fans, people 60 and older, as well as adults with disabilities, can take the following steps during high temperatures:

  • Increase fluid intake
  • Spend some time in cool or air-conditioned environments regularly
  • Reduce strenuous activity during the afternoon
  • Speak with their physician before summer about how to stay safe while taking medication that can affect the body’s ability to cool itself (e.g., high blood pressure drugs)

Given the spread of COVID-19, people should check on neighbors and friends aged 60 and older by phone or internet during high temperatures when possible. Visiting a cool space in the house of a neighbor or friend is recommended if one doesn’t have adequate cooling, but physical distancing of at least 6 feet, wearing a cloth face covering and handwashing should be practiced.

The program is made possible by donations from Duke Energy Carolinas, Duke Energy Progress, and Dominion Resources, which allow regional area agencies on aging and provider agencies to purchase fans for eligible individuals. Provider agencies can also purchase a limited number of air conditioners based on a person’s specific health conditions.

Last year, the division received $85,600 in donations, allowing for the distribution of 5,185 fans and 27 air conditioners.

For more details, individuals may contact their Area Agency on Aging or the NC Division of Aging and Adult Services’ Housing Program Consultant at 919-855-3419.More information about Operation Fan Heat Relief, including tips on preparing for extreme heat and a list of local agencies distributing fans, is available at https://www.ncdhhs.gov/operation-fan-and-heat-relief.

Additionally, weekly heat-related illness emergency department visit data is available at https://publichealth.nc.gov/chronicdiseaseandinjury/heat.htm.

Hope4NC and Hope4Healers: The Hope4NC Helpline (1-855-587-3463) connects North Carolinians to additional mental health and resilience supports that help them cope and build resilience during times of crisis. As part of the state’s recent hurricane recovery efforts it served over 4,400 people in the most impacted counties, and now it is being made available to everyone in North Carolina’s 100 counties during the COVID-19 crisis. This initiative is in partnership with all seven of the state’s LME/MCOs and REAL Crisis Intervention Inc. in Greenville. Hope4NC is now available 24 hours per day, seven days a week to speak to a live person.

The Hope4Healers Helpline (919-226-2002) is a new initiative in partnership with the North Carolina Psychological Foundation. It provides mental health and resilience supports for health care professionals, emergency medical specialists, first responders, other staff who work in health care settings and their families throughout the state who are experiencing stress from being on the front lines of the state’s COVID-19 response. Hope4Healers is also available 24 hours per day, seven days a week for people to reach out for support; they will be contacted quickly by a licensed mental health professional for follow-up.