In This Bulletin:
NC DHHS Secretary approves Cabarrus, Union move from Cardinal Innovations Healthcare to Partners Health Management
Cabarrus and Union counties were notified on April 9, 2021 that Mandy Cohen, MD, MHP, Secretary of the North Carolina Department of Health and Human Services (NC DHHS), has approved their requests for realignment with Partners Health Management (Partners). The realignment has an effective date of September 1, 2021 and was approved in accordance with NCGS § 122C-115(a3) and county disengagement rules.
NC Medicaid Managed Care Open Enrollment Ends May 15
NC Medicaid Managed Care statewide open enrollment will continue through May 15, 2021. Beneficiaries can enroll online, by calling the NC Medicaid Managed Care Call Center at 833-870-5500 (TTY: 833-870-5588) or through the free NC Medicaid Managed Care mobile app available on Google Play or the App Store. They can also use the mail-in forms sent to them in the enrollment packet.
Beneficiaries who enroll with a health plan during open enrollment will have the opportunity to select a PCP from a list of contracted providers. If they do not choose a health plan before May 14, one will be assigned to them by NC Medicaid. In the first 90 days after their coverage effective date, beneficiaries can change health plans for any reason. After that, unless there is a special reason, beneficiaries cannot change health plans until the next Medicaid recertification date.
For more information, beneficiaries can:
- Refer to the enrollment packets mailed to Medicaid beneficiaries.
- Visit https://www.partnersbhm.org/medicaid-transformation/.
- Visit the NC Medicaid Managed Care website
- Call the NC Medicaid Managed Care Call Center at 833-870-5500 (TTY: 833-870-5588).
NC Medicaid Ombudsman Information: NC Medicaid Ombudsman launches on April 15, 2021. Visit https://ncmedicaidombudsman.org/ to learn about this advocate for quality care. Providers can also download new informational materials to learn more about the Ombudsman and what managed care means for you and the people you serve.
Provider Training Needs Survey
Partners seeks feedback from our providers regarding training needs for next fiscal year. Please share your input by completing a brief survey by April 30, 2021. Take the survey.
Interested in Child and Family Team 1 Training? Let us know.
Partners is now able to offer the two-day Child and Family Team 1 trainings virtually. The classes have filled quickly. We would like to gauge the need for additional trainings. If you would like to attend a CFT 1 training or if your agency has staff who need to attend, please send an email to Jeanne Patterson, email@example.com with the number of people who would attend. Please remember participants must attend both days of this training.
- 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.
- AlphaMCS Portal University is an available resource and guide for navigating AlphaMCS. If you need additional claims training, email email@example.com 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.
Reminder: Taxonomy Code 193200000X: Taxonomy Code 193200000X should not be submitted on claims as the rendering taxonomy code. All claims submitted with this taxonomy code as the rendering code will be reverted.
|March 2021: Medicaid—Number of Days to Process and Pay All Claims|
|Received Date to Paid Date:||8.7|
|Top Five Medicaid Claim Denials for March 2021|
|Claim Denial||Provider Recommended Action Steps|
|Submitting Replacement Provider does not match original Provider.||Look at the RA with the original claim header and make sure you entered correctly.|
|Service is not authorized.||Verify Service Authorization for consumer/member. Contact Utilization Management.|
|Claim received after billing period.||Write off charges as non-billable. Do not rebill.|
|Duplicate claim.||The claim has previously been submitted and adjudicated. Do not refile.|
|Invalid PC/DX Combo.||Verify the procedure code corresponds with DX and all the information is submitted correctly. Refile only if incorrect.|
Frequently Asked Questions about Medication Administration Training, Part 1
Behavioral health and intellectual/developmental disability service providers should be aware of the expectations around the safe storage, administration and recording of medications due to the complexity of providing medical care to our members. With increased complexity comes increased risk: risk to the member of long-term health consequences including death; and risk to the provider of being out of regulatory compliance due to long-standing, habitual or entrenched improper practices.
Below are four frequently asked questions and answers about medication administration training. Use this self-assessment to determine what changes, if any, your agency should make to bring itself into compliance with regulations and protect the members you serve.
Question: Who can provide training on medication administration to unlicensed staff so that they may administer medications?
Answer: A Registered Nurse or Pharmacist must provide training on medication administration to unlicensed staff prior to the administration of medications.
Citation: 10A NCAC 27G .0209:
“Medications, including injections, shall be administered only by licensed persons, or by unlicensed persons trained by a registered nurse, pharmacist or other legally qualified person and privileged to prepare and administer medications.”
Question: Where can I find a training course on Medication Administration and Recording (MAR)?
Answer: You can find courses from the North Carolina Division of Health Service Regulation (DHSR) on its State-Approved Medication Administration Courses for Adult Care Homes website. The courses and a student manual can be downloaded for free from the North Carolina DHHS website.
Citation: NC Division of Health Service Regulation Adult Care Licensure Section:
Question: What is the proper way to store medications?
Answer: Proper storage of medications requires that you keep them in a locked cabinet, with a separate tray for external and internal medications. Medication that must be kept cool/cold may be put in a locking box in the main refrigerator.
Citation: 10A NCAC 27G .0209:
All medication shall be stored: in a securely locked cabinet in a clean, well-lighted, ventilated room between 59º and 86º F.; in a refrigerator, if required, between 36º and 46º F. If the refrigerator is used for food items, medications shall be kept in a separate, locked compartment or container; separately for each client; separately for external and internal use.
Question: What should happen when a dose of medication is missed or given incorrectly?
Answer: The staff administering medications must contact the physician or pharmacist immediately and record any medication errors on the Medication Administration Record (MAR) form.
Citation: 10A NCAC 27G .0209:
(h) Medication errors. Drug administration errors and significant adverse drug reactions shall be reported immediately to a physician or pharmacist…
A client’s refusal of a drug shall be charted.
Additional questions and answers will be shared in the May and June Provider Communication Bulletins. If you want to learn more or have a specific question, please reach out to Miccah Duckett, Program Integrity Investigator, at firstname.lastname@example.org.
State News and Updates
Providers are reminded to check Partners’ COVID-19 provider webpage and the NCDHHS COVID-19 Guidance and Resources for Medicaid Providers for the most up-to-date information. If you have questions, please email your provider account specialist or the Provider Network Help Desk at email@example.com.
North Carolina’s COVID-19 Vaccine Eligibility Open for All Adults: Vaccine eligibility for Group 5 (individuals 16 years and older) opened on April 7. You can visit https://covid19.ncdhhs.gov/vaccines to find your spot and take your shot.
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.
- #J392 Transitions to Community Living Initiative (TCLI) Extension
- #JCB391 State-Funded Community Living and Support Service Implementation
- Community Living and Support Service Definition (I/DD and TBI)
Medicaid Bulletins: All bulletin articles, including those related to COVID-19, are available on the DHB webpage. Providers are encouraged to review this information.
NCTracks: Providers are encouraged to review NCTracks communications. To subscribe to NCTracks communications, visit https://www.nctracks.nc.gov/content/public/providers/provider-communications.html.
NCTracks April 2021 NC Medicaid Webinar for Providers–Hot Topics in Medicaid Transformation
Thursday, April 15, 2021 from 5:30-6:30 p.m.(Register)
The launch of Medicaid Managed Care on July 1 is coming fast, and this webinar will keep you up-to-date on key details of the new system. Hot topics to be covered include:
- Pharmacy Coverage
- Durable Medical Equipment Coverage
- Health Equity Survey
- General Updates
- What-Ifs of Managed Care
- Questions and Answers
Upcoming Provider Meetings
Partners’ Provider Council: The Partners’ Provider Council is a professional representative and advocates for all service providers in the Partners’ catchment area. The Council facilitates an open exchange of ideas and brings forward concerns and solutions while promoting collaboration and mutual accountability among providers. Meetings are held on the fourth Friday of the month.
This month’s meeting will be held on Friday, April 23. Providers will meet beginning at 9:30 a.m.; Partners staff will join at 10:30 a.m. Click here to register.
Quarterly Provider Webinar: Join us for Partners Quarterly Provider Webinar on June 9 from 1-3 p.m. Updates and vital information will be shared with providers. To register, visit https://www.partnersbhm.org/events/quarterly-provider-webinar-2/.
CBT Learning Community
- April 21, 2021, 2-3 p.m., Online (Register)
- May 19, 2021, 2-3 p.m., Online (Register)
- June 16, 2021, 2-3 p.m., Online (Register)
Join likeminded providers in a learning community to explore skills, concepts, case studies, and expand your own techniques. This learning community will you learn practical ways to use evidence based practices in your day to day work with members. What do we do in this learning community: self-care, reduce burnout, professional growth, connection to a community, explore evidence based practices, gain a sense of mastery, invest in your own emotional bank account, improve in quality of care delivered, and learn and practice skills that are reimbursable.
Licensed Independent Practitioner Collaborative (LIP)
May 19, 2021, Noon-1 p.m. (Register)
The Licensed Independent Practitioner (LIP) collaborative was developed to improve communication between Partners and Licensed Independent Practitioners. Meetings are held quarterly via webinar. The LIP Collaborative will also meet on Aug. 18 and Nov. 17. Learn more about the LIP Collaborative at https://providers.partnersbhm.org/licensed-independent-practitioners-collab/
Partners’ Roundtable Discussion: Delivery of Psychological Testing and Evaluations: Partners is hosting a roundtable discussion to collaboratively develop solutions and interventions that will address the challenges/barriers that providers experience in delivering psychological testing and evaluations. Partners is engaged in a participatory planning effort to improve and increase network capacity for a continuum of Psychologists (PHD and/or PsyD) and Licensed Psychological Associates, including individuals and groups, to perform psychological evaluations for Medicaid, State–funded and Medicare members. The psychological services are designed to meet our continuum of care needs for our members living with mental health disorders and intellectual/developmental disabilities.
Partners’ Roundtable Discussion: Delivery of Psychological Testing and Evaluations will be held virtually on May 19, 2021 beginning at 1 p.m. Registration is required, click here to register.
As part of this initiative, Partners is requesting provider support and assistance to perform comprehensive psychological evaluations for members receiving Innovations waiver services, those on the I/DD Registry of Unmet Needs, children with complex needs, and individuals receiving residential, day and/or periodic services.
Partners is currently experiencing a need for additional providers of these services in Burke, Catawba, Rutherford, Surry and Yadkin counties, and is seeking Psychologists and Licensed Psychological Associates who are willing to provide any of the following services for our members:
- Conduct assessments for children, adolescents and adults for the purposes of diagnostic assessment to aid in treatment planning for members to receive the right type of care and services.
- Level of care.
- Comprehensive psychological Assessments across the lifespan, including the following:
- Social History
- Adaptive Behavioral Composite test/score
- Full Scale IQ Score
- Conduct assessments of children and adults utilizing best practice standards in the field of Autism and Intellectual Developmental Disability.
- Attest to a member’s history of an Intellectual/Developmental disability prior to the age of 18 obtained by family interviews, reviewing pervious school records and/or other psychological assessments.
- Ability to perform Mobile Psychological Assessments.
If you have questions about the roundtable or the services mentioned, please contact Lisa Jordan, Provider Network Manager, at firstname.lastname@example.org.
Partners’ Trainings for Members, Providers and the Community
All training sessions are free to registered attendees. Register in advance at www.PartnersTraining.com. If you have any questions, please email email@example.com.
Training for Providers
Partners’ Training Library: Are you looking for a recent presentation from a previous Partners’ Training Academy event? Our on-demand training library is available as a resource in the Partners Training Academy. Presentations are listed in chronological order, from newest to oldest. Find slide decks, tip sheets and video tutorials. https://www.partnerstraining.org/training-library/
Provider Training: Transition of Care for Standard Plans
April 15, 2021, 1:30–3 p.m., online (Register)
This live webinar will provide information that providers need to know in order to successfully navigate the Standard Plan transition beginning July 1, 2021. A recording of the webinar training will be posted to the Partners training calendar for additional viewing opportunities in late April and early May. This course does not offer NBCC credits.
Trainers: Partners Health Management
Target Audience: All providers
Mindfulness and Recovery
April 27 and April 29, 2021, 9 a.m.-12:30 p.m. (Register)
Mindfulness is now the fastest-developing area in mental health. Mindfulness is now the fastest-developing area in mental health. Learn more about the benefits of mindfulness and the ways it applies to the recovery process. This is a two–day training. You will need to attend both sessions to receive full credit.
This is a virtual live event; you will need to participate using audio and video capabilities. This course does offer six hours of NCSAPPB CEs. If you cannot access audio and video, you will need to wait to take a face-to-face class. If you are not participating by video, you will be removed from the session.
NCSAPPB approved 20-211-S. Up to 6 hours SS (PSY)
Treating Substance Use Disorders During the Modern Opioid Epidemic
May 5, 2021, 9 a.m.-12:30 p.m., online (Register)
Utilizing medications combined with Cognitive Behavioral Therapy has become the “gold standard” for treating opioid use disorders. What does that mean for you and your current role as a helper within the treatment system or recovery community? Examine the scope of the current problem and its historical context. Explore the solution from a bio-psycho-social-spiritual perspective that includes the possible application of pharmaceutical interventions combined with therapy, and the role that 12 step plays.
Training will take place over two days. Participants will have to be present with audio and visual capabilities for all sessions to receive credit. No Partial credit will be given. This is a virtual live event; you will need to participate using audio and video capabilities. If you cannot access audio and video, you will need to wait to take a face to face class. If you are not participating by video, you will be removed from the session.
NCSAPPB approved for up to 6 hours 20-581-S
Provider Open House
May 6, 2021, 9 a.m.-11 a.m., online (Register)
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 attendee time to work one-on-one with Partners’ staff to discuss any issues, questions or unfamiliar topics.
For this session, we will be using Zoom and breakout rooms. These sessions will not have a formal presentation or start time but are the providers’ time to meet one-on-one with Partners’ staff for technical assistance.
Target Audience: Providers new to Partners’ network or who may have questions for subject matter experts.
Permanent Supportive Housing (PSH)
May 11, May 13, May 18, and May 20, 2021, 8 a.m.-12:30 p.m., online (Register)
Partners has scheduled a series of virtual trainings on the evidence-based model for Permanent Supportive Housing (PSH). With the policy change, CST providers are to offer ongoing, tenancy support services. This training will support ANY provider by improving their understanding and practice of the PSH model. Experienced and certified PSH trainers from the Technical Assistance Collaborative (TAC) have created the training. These sessions will be facilitated by TAC trained Partners’ staff. This is a virtual live event; you will need to participate using audio and video capabilities. If you cannot access audio and video, you will need to wait to take a face-to-face class. If you are not participating by video, you will be removed from the session. You must attend all four sessions of training to receive credit.
Trainers: Carolyn Shoaf and Michelle Stroebel, Partners Health Management
Target Audience: All CST staff members (15 hours of Tenancy Support Training must be completed within 90 days of hire. This training meets that requirement), ACTT, TCLI, and any housing staff.
Cultural Competency: CLAS Standards
May 12, 2021, 1 p.m.-4:30 p.m., online (Register)
The Office of Minority Health has established Culturally and Linguistically Appropriate Services (CLAS) standards to address health equity and improve outcomes. This training will not only review the standards but review the wealth of tools and training materials available free of charge to providers. This course does not offer NBCC credits.
Trainers: Carolyn Shoaf and Michelle Stroebel, Partners Health Management
Target Audience: All providers.
May 14 and May 21, 2021 (two-day training) 8:30 a.m.-5 p.m., online (Register)
Join Partners Training Academy for this two day, interactive virtual live training that will cover the fundamentals of Motivational Interviewing (MI). This training will be done by a MINT trainer and will meet NC service definition training requirements. This is a virtual live event; you will need to participate using audio and video capabilities. If you cannot access audio and video, you will need to wait to take a face–to–face class. If you are not participating by video, you will be removed from the session. You must attend both days of training to receive credit. No partial credits will be given.
Partners has been approved by NBCC as an Approved Continuing Education Provider,
ACEP No. 6932. Programs that do not qualify for NBCC credit are clearly identified. Partners is solely responsible for all aspects of the programs.
Trainers: Tammi Grossens, Certified MINT Trainer
Target Audience: All providers
Racism, Resistance, and Rap
May 25 and May 26, 2021, 9 a.m.-12:30 p.m., online (Register)
Join Partners Training Academy in a journey of learning through Racism, Resistance, and Rap: Using hip hop to explore and properly handle the origin of your Clients’ Rage against Institutional Racism. Hip Hop is an art form that was birthed out of The Bronx New York in the late 70’s by black and brown residents faced with extreme poverty and systematic violence. It is now a global brand with a following that spans race, class, and socio-economic lines. Sometime after the release of their famous single “Fight the Power” Chuck D was quoted saying “Hip Hop is Black people’s CNN”. The statement may not be entirely accurate, but with closer analyzation of popular song lyrics we begin to see that much of the content provides a transparent reflection of the rich tapestry of American culture. What if we could somehow use some of the elements of Hip Hop to have conversations with people about mental health and community violence? This is a 2-session virtual live event; you will need to participate using audio and video capabilities.
Trainers: Andrew Watkins, LCSWA
Target Audience: All providers
CST Service Definition Webinar
May 26, 2021, 8:15 a.m.-noon (Register)
The CST Service Definition training is a recorded webinar training that will offer registrants basic knowledge needed to learn of the changes to the Community Support Team service definition, including additional responsibilities for permanent supportive housing and UM requirements. There are two breaks during this recorded training. Participants will be required to pass a 10 question quiz at the conclusion of the webinar. This course does not offer NBCC credits.
DBT Skills Training
May 27, 2021 10:00 a.m. – 12:30 p.m., online (Register)
Join Partners Training Academy virtual session to dig deeper into the Four DBT Skills (Mindfulness, Interpersonal Effectiveness, Emotional Regulation. and Distress Tolerance). Session will focus on introducing and reinforcing skill use with members. Teaching clients new skills is the heart of behavior change, and this session will teach you strategies to be an effective skills trainer. You don’t have to be a Dialectical Behavior (DBT) therapist for your clients to benefit from the DBT skills. Anyone who works with members can learn, apply, and teach these skills as an accompaniment to any current treatment models. This is a virtual live training requiring video and audio participation.
Trainers: Lori Breland, MA, NCC, LCMHCA
Target Audience: All providers
Community Events and Training
You can find more training opportunities at www.partnersbhm.org/event-calendar/
QPR (Question Persuade Refer) Suicide Prevention
April 22, 2021, 2-4 p.m., online (Register)
Many of us are isolated because of social distancing. Many have experienced losses. The risk of suicide is higher than ever. This training teaches the skills to intervene in a suicide crisis.
Note: the maximum number of people allowed to participate in a virtual QPR training at one time is 30; registration is on a first come first serve basis.
Human Trafficking During Quarantine: Keeping Our Children Safe
April 23, 2021, 1-3 p.m., online (Register)
Many of us are still working from home and our children may be learning from home as well. Children may spend more time online than usual. Learn about trafficking and how to keep our children safe.
Domestic Violence During COVID-19: How to Help
April 27, 2021, 2-4 p.m., online (Register)
Many of us are still home more than usual and the risk for domestic violence is high. Learn how to spot the signs of domestic violence and how to help.
Darkness to Light
April 30, 2021, 10 a.m., online (Register)
Darkness to Light provides education about child sexual abuse and the steps you can take to prevent and report child sexual abuse. This training is offered two times in April. You may register for either one. After you register you will receive a confirmation email about joining the meeting and how to access the Darkness to Light training manual and personal prevention plan.
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
2021 Surry County Autism Walk: As many as 1 in 54 children may be diagnosed with autism in the United States. You can make a difference in the lives of children with autism and their families by registering for the Surry County Walk for Autism. Registration for the walk with an event T-shirt is $15 ($20 for 2XL or 3XL). You can make an even bigger impact by recruiting family members, friends, and co-workers to form a team and raise donations.
During the week of April 17-24, participants are invited to complete their walk and fundraise to help support local programs and services. Proceeds from the Virtual Surry Walk for Autism will fund local programs of the Autism Society of North Carolina, the leading statewide resource organization serving the people in NC across the spectrum throughout their lifespans. Everyone knows someone affected by autism—maybe your brother, cousin, friend at school, neighbor, or co-worker. Join others to make a difference in the life of someone you care about with ASD. You can help! If you have questions, please email us, call 800-442-2762, ext. 1106, or visit http://support.autismsociety-nc.org/site/TR?fr_id=1340&pg=entry to learn more.
Updated Federal Poverty Level (FPL) Standards: The Centers for Medicare and Medicaid Services has released a Medicaid Information Bulletin with the updated 2021 Updated Federal Poverty Level (FPL) Standards. Read the bulletin.
SAMHSA Homeless & Housing Resource Center is offering the following webinars:
Improving Equity and Inclusion in SOAR Programs
Wednesday, April 21, 3-4:30 p.m. (Register)
Ensuring equity in SOAR program implementation requires providers to consider how implicit bias may contribute to disparities in how SOAR services are accessed by and delivered to diverse groups. On this webinar, the SAMHSA SOAR TA Center will address barriers to equity in SOAR implementation and present strategies to overcome them.
Addressing the Critical Need for Housing and Strategies to Overcome Barriers to Improve Housing Access
Thursday, April 22, 2-3 p.m. (Register)
Housing is a critical need for individuals experiencing homelessness who are in crisis and at risk for justice involvement. Services alone cannot address the overwhelming disruption homelessness contributes to well-being and health. Barriers to accessing housing include criminalization of homelessness, lack of partnership development, funding issues, and myths and realities related to securing housing. This webinar’s presenters will address comprehensive strategies to improve housing access, which is key to early diversion. A discussion group will follow the webinar from 3:00-4:00pm ET.
Integrating Recovery Supports into Services for People Experiencing Homelessness
Tuesday, April 27, 2–3 p.m. (Register)
C4 Innovations, an Opioid Response Network (ORN) partner organization, invites you to join a conversation with national leaders about why access to recovery supports is critical for people experiencing homelessness. Presenters will explore evidence-based and best practices for engaging individuals with Opioid Use Disorder (OUD) and experiencing homelessness to connect them with available recovery supports.
SAMHSA has published an update of Technical Assistance Publication (TAP) 34, Disaster Planning Handbook for Behavioral Health Service Programs, making available another tool to help support the response to COVID-19. The updated TAP provides guidance for developing or refreshing a comprehensive disaster plan. Topics include continuity planning, management of prescription medications, pandemic disease (including COVID-19), and testing and using the plan. The TAP also features worksheets to help guide program leaders through the disaster planning process.
2021 Employment and Transition Webinars: NCCDD is hosting a series of ten Employment and Transition Webinars starting today, April 15, 2021 from 9:30 a.m.-12:30 p.m. to educate and inform stakeholders about a statewide system that provides and sustains integrated employment for all North Carolinians living with a developmental disability, regardless of complexity or needed level of support. Learn more.
Planning to be a CMA or AMH+? Let us know. Is your agency interested in becoming a Care Management Agency (CMA) or Advanced Medical Home Plus (AMH+)? As Medicaid Transformation moves forward, Partners would like to know which agencies are applying for certification as a Care Management Agency (CMA) or Advance Medical Home Plus (AMH+). Please help us by completing this survey.