Partners March Provider Webinar

Partners will host its next Provider Webinar on Wednesday, March 13 from 1 p.m.-3 p.m. To register for the webinar, click here. To view past webinars, slide decks, and handouts, please visit https://providers.partnersbhm.org/provider-webinars-forums/.

  • If you have a question about the topics scheduled for discussion, or any provider operations matter, please email your question to questions@partnersbhm.org.
  • We are setting aside time for up to three network providers to present during each webinar. We invite you to use this time to highlight new services, provide education about referral processes, update peers on your agency’s service expansion.

Please contact Roanna Newton at 828-323-8054 or email rnewton@partnersbhm.org with any questions or to arrange a time on the agenda.

Clinical Practice Guidelines

Partners has updated its Clinical Practice Guidelines. The guidelines can be found at https://providers.partnersbhm.org/clinical-practice-guidelines/.

Benefit Plans

Partners has updated the following Benefit Plans. All Benefit Grids can be found at https://providers.partnersbhm.org/benefit-grids/.

  • Medicaid Child Mental Health/Substance Use Services Benefit Plan
  • Medicaid Adult Mental Health/Substance Use Services Benefit Plan
  • State Adult Mental Health/Substance Use Services Benefit Plan
  • State Child Mental Health/Substance Use Services Benefit Plan

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. 

Timely Filing Override RequestsPlease make sure claims are being submitted according to the timely filing guidelines available at https://providers.partnersbhm.org/claims-information/.  If claims are denied for any of the reasons below, make sure you submit timely filing override requests within the time frames. Timely Filing Requests should be sent directly to claimsdepartment@partnersbhm.org prior to submitting the claims.

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.

Medicaid—December 2018:   Number of Days to Process and Pay All Claims
Received Date to Paid Date: 11.4
Top Five Medicaid Claim Denials—December 2018

Claim Denial

Provider Recommended Action Steps

Claim received after billing period Write off charges as non-billable. Do not rebill.
Service is not authorized Verify Service Authorization for consumer. Contact Utilization Management.
Duplicate Claim Claim has previously been submitted and adjudicated. Do not refile.
Client has other covered insurance (COB) Ensure that the primary insurance for the patient has been billed and is indicated on the claim being billed to the MCO.
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.

2019 Point in Time Count

Each year during the last week in January, communities across America come together with the same mission of counting individuals who are sleeping in an unsheltered environment. This count is a snapshot of the current demographics of homelessness and provides valuable data that helps to track progress towards the goal of ending homelessness over time. Policy makers and program administrators use this data to help determine funding and examine the effectiveness of HUD housing programs.

Collecting this data is possible through the efforts of trained organizers and volunteers. The efforts for each county are organized through the Continuum of Care for each area. Each year, Partners’ Housing Team assists with the planning and conducting of the count. Volunteers are needed in each county in our catchment area to assist with the planning and implementation. Donations are also needed for blankets, toiletries, gloves, and socks.

If you would like to be involved or make a donation, please contact someone from our Housing Team:

Mollie Tompkins
Serving Surry, Yadkin, and Iredell
Phone: 336-527-3259
mtompkins@partnersbhm.org 

Teena Willis
Serving Catawba and Burke
Phone: 828-323-8084
twillis@partnersbhm.org  

Bre Griffin
Serving Gaston, Cleveland, and Lincoln
Phone: 704-884-2514
bgriffin@partnersbhm.org

UPCOMING EVENTS

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.

Measurement Based Care Webinar (Registration)

Date and Time:  Wednesday, January 23, 2019, 10:00 a.m. – 12:00 p.m., Webinar

Description: Measurement Based Care (MBC) is an Evidenced Based Practice using patient-reported data to inform clinical care. Objectives include gaining insight on benefits of MBC, increasing understanding of MBC in various clinical settings, and learning about Partners’ role in implementation of MBC as it relates to Whole-Person Integrated Care.

Trainer: Danielle Kincaid, MA, LPC, Integrated Care County Lead, Partners

Youth Mental Health First Aid (Registration)

Date, Time and Location:  Tuesday, January 29, 2019, 8:30 a.m. to 5:00 p.m., Hickory

Description: A young person you know could be experiencing a mental health or substance use problem–learn an action plan to help. Youth Mental Health First Aid is recommended for individuals over 18 who regularly have contact with young people– teachers, coaches, social workers, faith leaders and other caring citizens are encouraged to attend this training.

Trainer: Kim Rhoads, System of Care Child Liaison, Partners

Population Health (Registration)

Date and Time:  Wednesday, February 13, 2019, 8:30 a.m. to 5:00 p.m., Webinar

Description: Want to learn more about Population Health? Population Health is critical to understanding the determinants of health of the populations we serve, identify the impact on the population(s) and act to improve the health of the population.  Population Health includes outcomes of a group of individuals, patterns of health determinants, and policies and interventions that link these two.

Objectives of the Webinar:

  1. Determining the current health of the population by measuring health status indicators;
  2. How to use information to identify populations with poor health that could benefit from some sort of intervention and assess what the target level should be.
  3. Apply the resulting knowledge to identify and reduce disparities in health across population groups.
  4. Ensure that initiatives to improve the health of the Medicaid (or any) population include the collection of measures and methodologies that can be used to assess the baseline health of that population and changes to health over time.

Trainer: Allison Gosda, Integrated Care Director, Partners

Ethics of Cultural Competency (Class Full)

Date, Time and Location:  Wednesday, March 6, 2019, 9:00 a.m. – 4:00 p.m., Hickory

Description: This unique interactive experience is an exploration of what “cultural competency” means in today’s world, from the perspective of how cultural influences impact our perceptions, particularly in behavioral health-related businesses. A range of culturally relevant topics will be addressed that directly impact the worldview and ethical behavior of professionals. Several group activities will be interactive, and experiential activities will be used to examine and discuss into these topics in relevant and meaningful ways.

Trainer: Joanna Linn, Ph.D., LPCS, LCAS, CCS, Thrivilege, PLLC, and Michele Edelen, MBA, Policy Advisor for Community Affairs, NC Division for Mental Health, Developmental Disabilities, and Substance Abuse Services

Healthcare Improvement Webinar (Registration)

Date and Time:  Wednesday, March 13, 2019, 10:00 a.m. – 12:00 p.m., Webinar

Description: This training will help participants understand how integrated care serves as an avenue for healthcare improvement. Healthcare improvement efforts lead to services being delivered in a more efficient and clinically appropriate manner to be able improve the wellbeing of individuals and communities. Participants will develop a baseline understanding of healthcare improvement, how Partners approaches quality improvement, and the role of value-based contracting in the improvement process.

Trainer: Jennifer Greene, MA, LPC, Integrated Care Project Manager, Partners

The Building Blocks of the ASAM Severity Profile (Registration)

Date, Time and Location:  Friday, March 29, 2019, 9:00 a.m. to 4:00 p.m., Hickory

Description: The American Society of Addiction Medicine (ASAM)’s treatment criteria provide separate placement criteria for adolescents and adults to create comprehensive and individualized treatment plans. The Mental Health/Substance Use Care Managers in the Utilization Management Department at Partners BHM invite you to participate in a full day of training on the six dimensions, where we will demonstrate how to build an ASAM Severity Profile to help develop and enhance your treatment plan. Training also includes several case vignettes that we will practice scoring together to assist with teaching the learner how to identify the most appropriate level of care placement.

This training is pending approval of 5 North Carolina Substance Abuse Professional Practice Board (NCSAPPB) credit hours.

Trainer: Partners MH/SU Utilization Management Department

Register online and find additional training opportunities at www.PartnersTraining.org.

State News

JCB #J316—Reporting and Release Requirements for the Incident Response and Improvement System:  Partners encourages all providers to review Joint Communication Bulletin #J316 that offers updated information regarding the requirements for submission of incident reports. If you have questions, please email iris@partnersbhm.org or call 704-772-4294.

IPS Service Definition Webinars:  This past week the new, revised Individual Placement And Support service definition was published. DHHS is conducting three webinars to review the changes and answer any questions. The first webinar will be for LME/MCOs only and the last two will be for providers and LME/MCO’s.  If you are an IPS Supported Employment Provider, please make sure you attend one of these two opportunities:

IPS Service Definition Revisions (Webinar for Providers and LME/MCOs)

Date and Time:  Friday, February 8, 2019, 11:00 a.m.

Event address for attendees: https://dsohf.webex.com/dsohf/onstage/g.php?MTID=edbb929938ffb6d97117e1437acfeac28

Event number: 664 159 577
Event password: 0208

To join by audio, please dial 1-888-273-3658; Access Code: 2490768#
To Mute or Unmute your line, press *6

IPS Service Definition Revisions (Webinar for Providers and LME/MCOs)
Date and Time:  Wednesday, February 13, 2019, 11:00 a.m.

Event address for attendees: https://dsohf.webex.com/dsohf/onstage/g.php?MTID=ec57b9a05f6b8e9c4a65f7f4c399f761e

Event number: 663 755 802
Event password: 0213

To join by audio, please dial 1-888-273-3658; Access Code: 2490768#
To Mute or Unmute your line, press *6

If you have questions regarding these webinars, please contact Tara Alley, DMH/DD/SAS-Community Services and Supports at tara.alley@dhhs.nc.gov.

Alerts and LME/MCO Joint Communication Bulletins

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 (Provider Alerts, the Provider Bulletin, or Behavioral Health Focus), please visit https://www.partnersbhm.org/subscribe/.

Alerts issued since the last Provider Bulletin:

All LME-MCO Joint Communication Bulletins are located at http://www.ncdhhs.gov/divisions/mhddsas/joint-communication-bulletins.

Joint Communication Bulletins issued since the last Provider Bulletin:

  • JCB 312—Quarterly Meetings Between LME-MCOs and State-Operated Psychiatric Hospitals
  • JCB 313—Income Verification and Income Verification Worksheet
  • JCB 314– SFY 2019 Network Adequacy and Accessibility Analysis Requirements for North Carolina LME-MCOs
  • JCB 315—Temporary Extension of North Carolina’s 1915 (b) Waiver and Concurrent 1915 (c) NC Innovations Waiver
  • JCB 316—Reporting and Release Requirements for the Incident Response and Improvement System
  • JCB 317—REVISED Individual Placement & Support (IPS) Service Definition

Providers are encouraged to review the monthly Medicaid Bulletin. Bulletins are posted at https://medicaid.ncdhhs.gov/providers/medicaid-bulletins.

Training, Announcements and Reminders

Partners’ Provider CouncilPartners’ Provider Council will meet on Friday, Jan. 25, 2019, at Partners’ Hickory Office, Basement Multipurpose Room. Providers meet from 9:30-10:30 a.m., and Partners’ employees join the meeting from 10:30 a.m.-12 p.m. The Partners’ Provider Council is a professional representative and advocate 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. All providers are welcome to attend Provider Council meetings. To learn more, please visit https://providers.partnersbhm.org/provider-council/.

Autism Services Learning Collaborative: Partners is introducing an Autism Services Learning Collaborative as an opportunity for providers of Adaptive Behavioral Treatment/Research Based-Behavioral Health Treatment (ABT/RB-BHT) and Partners’ employees to meet periodically as we work to expand the continuum of care available to children diagnosed with Autism.

Date, Time and Location:  Tuesday Jan. 29, 10 a.m.-12 p.m., Partners’ Gastonia-New Hope Office, 901 S. New Hope Rd., Gastonia, NC 28054

Who should attend?  Adaptive Behavioral Treatment Providers, RB-BHT Providers, Clinical Directors/Supervisors, Board Certified Behavior Analysts, Quality Management staff. Representation from all ABT/RB-BHT service providers will ensure the success of this collaborative, so we hope to see you there! Employees from Partners’ Care Coordination, Provider Network, System of Care, and Utilization Management departments will also be in attendance.

Goals of this collaborative:

  • To expand the use of Evidence Based Practices for children diagnosed with Autism in order to promote positive outcomes.
  • To identify and reduce barriers to treatment
  • To collaborate with other providers across the entire Partners’ System of Care
  • To explore how Partners can better support you

Please RSVP and send any questions to Sara Wilson at swilson@partnersbhm.org.

Health Information Exchange/NCTracks Updates

All providers must be enrolled in NC HealthConnex by June 1, 2019 or have a State-Approved Extension by that date to continue to receive payment.

Providers are reminded to pay attention to notifications from NCTracks for the latest information regarding a variety of topics, including recredentialing and NC HealthConnex. You can sign up for emails from NCTracks by visiting https://www.nctracks.nc.gov/content/public/providers/getting-started.html.

Managing Pain in the Age of the Opioid CrisisThis event was cancelled due to the hurricane. All previous registrants for the Sept. 15 training will need to re-register.

This inter-professional event will provide timely and relevant continuing education for medical prescribers and behavioral health professionals amid the opioid crisis. Topics include evidence-based analysis of the relative effectiveness of medications and their side effects, treatment recommendations for acute and chronic pain, and recognizing substance use/opioid use disorder (SUD & OUD), as well as statistics and nuanced data on prescribing and substance abuse patterns in Gaston County. The North Carolina Medical Board will provide important updates in state laws and explore legal and ethical dilemmas associated with prescribing opioids in North Carolina.

Date, Time and Location:  Saturday, Jan. 26, 2019 (Snow date: Feb. 2) at Gaston County DHHS, 330 Dr. Martin Luther King Jr. Way, Gastonia, NC 28052 from 7:30 a.m.-12:30 p.m.

The event is free; however, registration is required.

To register, please visit https://mahec.net/event/57808. For more details, please contact Mountain AHEC at registration@mahec.net.

Parents Supporting FamiliesAn Introduction to Peer Support for Families with Children Who Have Mental Health or Substance Abuse IssuesIndividuals with personal experience can learn how to use their experience in parenting a child who has a mental health or substance abuse issue to support other parents. Topics covered during this training:

  • How to Share your Story
  • Who is a Family Partner?
  • Requirements to be a Certified Family Partner
  • Understanding Grief
  • Core Values and Principles of System of Care
  • Conflict Resolution
  • Futures Mapping

This training is mandatory for National Certification and future NC Medicaid billing. The structure of the training is a three-day training with a two-day follow-up. During the two-day follow-up training, you will receive a certificate of completion.

Date, Time and Location:  Monday, Feb. 4 – Wednesday, Feb. 6, 2019 from 9 a.m.-4 p.m., Catawba Valley Behavioral Health, 20 4th Street SW, Hickory, NC 28602
Registration:  Registration is required. To register, call NC Families United at 336-395-8828 or email Renee Cordero at CorderoRH@gmail.com.

NAMI Lake Norman/Iredell Offers Mental Health ClassesNAMI Peer-to-Peer is a free, eight-session educational program for adults with mental illness who are looking to better understand their condition and begin a journey toward recovery. This in-person group experience provides the opportunity for mutual support and positive impact. You can experience compassion and reinforcement from people who relate to your experiences. Through your participation, you have the opportunity to help others grow. This is a confidential place to learn from shared experiences in an environment of sincere, uncritical acceptance. Recovery is a journey, and there is hope for all people living with mental illness.  To learn more, visit https://www.nami.org/Find-Support/NAMI-Programs/NAMI-Peer-to-Peer

This free, eight-week course is being taught by a team of trained NAMI volunteers. Classes will be held weekly beginning on Saturday, Feb. 9, 2019 from 11:30 a.m. to 1:30 p.m. at Fifth Street Ministries, 1421 5th St, Statesville, NC 28677. To register or receive more information, please contact Mike Hoffman at 843-245-6189 or via email at hoffmanm679@gmail.com. Space is limited to the first 25 registered participants.