NC Innovations Provider ChangesOut-of-State Services Requests (New Submit Via Email and New Updated Form)

Previously, when an individual receiving Innovations Waiver services was to travel out of state and require the continued support and services of their Innovations provider, the Provider Qualified Professional (QP) would fax an “Out-of-State Request Form” to the Partners IDD Care Coordinator’s supervisor for review and approval.

Partners has identified that this process could potentially leave some requests unanswered if the QP did not know which supervisor to send the request to, or if the assigned supervisor was out of the office and unable to respond to the request.

Partners has now created a centralized email address for the Provider QP’s to submit the request forms which will be distributed to the correct supervisor or designee to be reviewed and processed.

Partners has also updated the request form. The new form can be obtained from our Partners Provider Site at https://providers.partnersbhm.org/nc-innovations/. Please discard your old forms and use the new updated form.

Effective immediately, please send all completed request forms to IDDSupport@partnersbhm.org.

If you have any questions, please email either Rachael Jerzak, IDD Care Coordination Manager for Cleveland, Gaston or Lincoln Counties at rjerzak@partnersbhm.org or Wyatt Bell, IDD Care Coordination Manager for Burke, Catawba, Iredell, Surry and Yadkin Counties at wbell@partnersbhm.org.

Benefit Plan End Date Reminder for Adults and Children

Providers are reminded that, when submitting an enrollment or an update for State/IPRS funding to Partners’ Eligibility and Enrollment Department, all benefit plans for adults will have the end date of 12/31/2099, with the exception of ASOUD benefit plans. For children, the benefit plan end date will be the day before the child’s 18th birthday.  Any questions can be directed to EligibilityandEnrollment@partnersbhm.org.

Timely Submission of IRIS Incident Reports

Providers are reminded that IRIS Guidelines require all Level II and III incident reports to be submitted to IRIS within 72 hours of first learning of the incident. The North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (NC DMHDDSAS) requires Partners to submit quarterly health and safety performance data, which includes the number of Level II and III incidents that were submitted within the required timeframes. The minimum required performance benchmark for this measure is 85% of all Level II and III incidents must be submitted within 72 hours of first learning of the incident. For the fiscal year 2018-2019, Partners’ current performance for this measure is 86.3% (of the 1638 total submitted Level II and III incidents, 224 incidents were submitted late).

Partners strives for 100% compliance with all Health and Safety performance measures. To be successful, providers must submit timely incident reports. Guidelines for IRIS reporting are contained in the IRIS manual at https://files.nc.gov/ncdhhs/documents/files/incidentmanual2-25-11.pdf. In addition, providers may direct questions about IRIS reporting by email to IRIS@partnersbhm.org.

Request for Proposals–Comprehensive Substance Use Services (RFP #0319-002)

Partners are initiating this Request for Proposals (RFP) to solicit responses from appropriately qualified organizations to provide services, as outlined in this RFP, to program enrollees eligible due to a mental health, intellectual or development disability or substance use disorder.

The purpose of this RFP is to identify appropriately qualified organizations for the provision of Comprehensive Substance Use services.  The location for services is within Partners catchment area, specifically Surry and Yadkin Counties.  The organization providing services must have the capability and capacity to provide the needed services as well as demonstrate use of evidenced-based practices and a strong system for outcomes measurement.   Through this RFP, Partners will increase the network availability of this service.

The RFP offers an overview of Partners, the requirements to submit a proposal, and links for additional resources.  Please review the RFP and if you are interested in being considered for provision of these services with Partners, please follow the instructions within the RFP and the following tabs.

To view this RFP, please visit https://providers.partnersbhm.org/request-for-services/.To be considered for provision of this service, you must

  • have attended the Mandatory Bidders Conference on February 28, 2019
  • follow the required RFP format and
  • submit your proposal to the RFP by April 19, 2019, by 5 p.m.

Issuance of an RFI or RFP does not guarantee a financial award, nor does it indicate a commitment on the part of the issuer to pursue further contractual relationship.

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 deny 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.

Explanation of Benefits requests for Coordination of Benefits Claims:  As a reminder, Partners does request copies of the Explanation of Benefits for consumers/claims submitted indicating Coordination of Benefits. The request will originate via email from Partners Claims staff.

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.

Medicaid—February 2019:   Number of Days to Process and Pay All Claims
Received Date to Paid Date: 8.9
Top Five Medicaid Claim Denials—February 2019
Claim Denial Provider Recommended Action Steps
Service is not authorized Verify Service Authorization for the consumer. Contact Utilization Management.
Claim received after the billing period Write off charges as non-billable. Do not rebill.
Duplicate Claim The claim has previously been submitted and adjudicated. Do not refile.
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.
Billing Taxonomy submitted is not associated with the Billing NPI. Rebill claim with a valid taxonomy/NPI information.

What’s in Your Compliance Toolbox?

Providers in Partners’ network are expected to develop a Corporate Compliance Plan that includes procedures designed to guard against healthcare fraud and abuse. A robust compliance plan can help you better serve your clients and help reduce the risk that your claims may be subject to pay-backs (overpayments). A good compliance program will ensure your services are provided, documented, and billed in accordance with federal, state and local MCO laws, rules and regulations.

Partners has developed and made many resources available to help providers stay in compliance with the requirements for serving the Medicaid beneficiaries in our service area.

One area of non-compliance that Partners’ Program Integrity Department sees often is a failure to properly document (CCA, PCP, LOC, service notes, etc.) the services rendered and billed. To reduce the likelihood that your claims may be subject to repayment, providers must adhere to the following:

Providers in Partners’ network can demonstrate that they are good stewards of the public funds that have been entrusted to us by performing Provider Self-Audits to identify areas of non-compliance. Self-Audits are just one tool that providers can utilize as part of a robust, internal compliance program.  Information on how to perform a self-audit can be found on Partners’ Provider Knowledge Base website: https://providers.partnersbhm.org/program-integrity/.

Partners Hosts Forum for Rutherford County Providers

On March 19, 2019, Partners hosted a forum for Rutherford County behavioral health providers. The forum was an opportunity for providers to learn what they can expect when doing business with Partners leading up to and after the transition effective July 1, 2019. We enjoyed meeting all who could attend and thank you for participating.

If you were not able to attend, you can view the presentation here. You may also direct questions to Rutherford_Questions@partnersbhm.org or call 704-884-2505.

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.

The Building Blocks of the ASAM Severity Profile (Class Full)

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

Team Based Care Webinar (Registration)

Wednesday, April 10, 2019, 10:00 a.m. – 12:00 p.m., Gastonia with video conference to Hickory and Elkin

Description: Team Based Care has the potential to improve the comprehensiveness, coordination, and effectiveness of care provided. Incorporating Team Based Care into your organization will lead to greater patient satisfaction and satisfaction among your team, essentially achieving the Quadruple Aim.

Learning Objectives:

  • Understanding of Team Based Care
  • Knowledge of why and how Team Based Care improves the value of care
  • Guidance on how to implement, or enhance, Team Based Care within your agency

Trainer: Kenneth Gehrig, Gaston County Program Lead, Partners

NEW! Person Centered Planning/Documentation

Wednesday, April 17, 2019 – Thursday, April 18, 2019, 9:00 a.m. – 4:30 p.m., Gastonia (Registration)

Thursday, May 30, 2019 – Friday, May 31, 2019, 9:00 a.m. – 4:30 p.m., Hickory (Registration)

Description: Documentation/Person Centered Planning Training – This training is an instructional course on the essential elements of documentation. Participants will develop awareness and skills to enhance documentation competence as behavioral healthcare providers. Participants will learn the components to writing accurate service notes using the PIE format. Additionally, participants will learn the values and core concepts of being person centered thinkers. This training will teach the instructional elements of completing the person centered plan.

Learning Objectives:

  • How to mitigate separating personal values, experiences, feelings, attitudes, and beliefs that may unconsciously influence the efficacy of clinical work
  • How to manage challenges that arise when documenting service notes while honoring the culture, values, beliefs and preferences of clients
  • How to incorporate person centered thinking methods, techniques, and tools into the development of the Person Centered Plan
  • How to effectively write a comprehensive clinical service note

Target Audience: Social Workers, Counselors, Psychologists, Qualified Professionals, Peer Support Specialists, Associate Professionals, Licensed Mental Health Providers, Community Based Mental Health Agency Directors

Trainer: Danielle Coleman, MSW, LCSW, ACSW

Collaborative Care (Registration)

Wednesday, June 12, 2019, 10:00 a.m. – 12:00 p.m., Gastonia with video conference to Hickory and Elkin

Description: Throughout the course of the year, Partners Training Academy has introduced to providers components of the Collaborative Care Model. This training connects those components together to go deeper in the application of Collaborative Care. Per the AIMS (Advancing Integrated Mental Health Solutions) Center, Collaborative Care is a specific type of integrated care developed at the University of Washington and adapted by Partners, that treats common mental health conditions that require systematic follow-up due to their persistent nature, such as depression and anxiety. Based on principles of effective chronic illness management, Collaborative Care focuses on defined patient populations tracked in a registry, measurement-based practice, and treatment to target.

Participants in this training will:

  • Review the core principles that make up the Collaborative Care Model
  • Enhance understanding of the Team Structure and Partners’ adaptations to the Collaborative Care Model Team Structure
  • Explore financing strategies
  • Address efforts to meet success in the community from clinical, financial and political perspectives

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

NEW! LOCUS (Registration)

Friday, September 13, 2019, 9:00 a.m. – 12:00 p.m., Hickory

DescriptionLevel of Care Utilization System for Psychiatric and Addiction Services – Service providers are required to use the Level of Care Utilization System for Psychiatric and Addiction Services, or LOCUS, a clinical tool to evaluate and determine the level of psychiatric or addiction services care needed for adults. This training is conducted by Partners’ Mental Health and Substance Use Utilization Management staff. This hands-on training includes the review of a case and the use of the LOCUS screening form to score the level of care needed.

Target Audience: Persons responsible for service authorization requests for mental health and substance use services.

Trainer: Partners BHM MH/SU Utilization Management Department

NEW! CALOCUS (Registration)

Friday, September 13, 2019, 1:00 p.m. – 4:00 p.m., Hickory

DescriptionChild and Adolescent Level of Care Utilization System for Psychiatric and Addiction Services – Service providers are required to use the Child and Adolescent Level of Care Utilization System for Psychiatric and Addiction Services, or CALOCUS, a clinical tool to evaluate and determine the level of psychiatric or addiction services care needed for individuals ages 6-18. This training is conducted by Partners’ Mental Health and Substance Use Utilization Management staff. This hands-on training includes the review of a case and the use of the CALOCUS screening form to score the level of care needed.

Target Audience: Persons responsible for service authorization requests for mental health and substance

Trainer: Partners BHM MH/SU Utilization Management Department

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

Opioid Lunch & Learn Series

Best Practices in Opioid Prescribing and Management: A CME Lecture Series, presented by Northwest Area Health Education, a program of Wake Forest School of Medicine and a part of the NC AHEC System.

Join Northwest AHEC at Partners’ offices for monthly opioid-focused lectures delivered in a lunch-and-learn format. Registered participants will receive lunch, and Continuing Education Unit(s) for each session attended on behalf of Northwest AHEC.

Continuing Education Credits:

Each course provides the following credit options after completing and passing a post-test and completing the online evaluation:

  • The Wake Forest School of Medicine designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • Continuing Nursing Education (CNE) Contact Hours

The Wake Forest School of Medicine is accredited by the Accreditation Council of Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

RegistrationAdvanced registration is required. Register online via the training calendar at www.PartnersTraining.org or the registration links.  Additionally, you are required to create a MyAHEC account if you do not already have one. Instructions to do so will be emailed to registered participants prior to their first lecture.

If you have any questions regarding the Opioid Lunch & Learn Series, please contact Kali Sbalbi, Training & eLearning Coordinator, at KSbalbi@PartnersBHM.org or 704-884-2669.

Program Topics and Objectives:

 “Responding to the Opioid Epidemic Effectively Using Team Based Care”

Review the historical events leading to the opioid epidemic, review the STOP Act requirements for providers, and discuss the role of each team member as a solution to the opioid epidemic

  • Gastonia Auditorium: April 16, 12:00 – 1:00 p.m. (Registration)
  • Hickory Multipurpose Room (B03): April 18, 12:00 – 1:00 p.m. (Registration)
  • Elkin Conference Room A/B: April 18, 12:00 – 1:00 p.m. (Registration)

“How to Approach Pain Management in Older Adults: Special Considerations and Treatment Options”

Gain familiarity with current trends in opioid prescribing and prescription opioid misuse in the United States, discuss age-related changes that affect pain management, and describe how to approach pain management in older adults

  • Gastonia Auditorium: May 14, 12:00 – 1:00 p.m. (Registration)
  • Hickory Multipurpose Room (B03): May 16, 12:00 – 1:00 p.m. (Registration)
  • Elkin Conference Room A/B: May 16, 12:00 – 1:00 p.m. (Registration)

“Strategies for Safe Opioid Discontinuation in Chronic Use Patients”

Define Opioid Use Disorders (OUD), review medications involved in OUD, identify strategies for opioid discontinuation, and describe medication assisted therapy (MAT) options

  • Gastonia Auditorium: July 16, 12:00 – 1:00 p.m. (Registration)
  • Hickory Multipurpose Room (B03): July 18, 12:00 – 1:00 p.m. (Registration)
  • Elkin Conference Room A/B: July 18, 12:00 – 1:00 p.m. (Registration)

System of Care Training

Child and Family Team 1 Team Training (Registration)

Date, Time and Location:  April 8 and 9, 2019, 9:00 a.m. to 5:00 p.m., Gastonia

Description: Child and Family Team 1 is a two-day experiential training with a goal of providing an overview of Child and Family Team meetings from the family’s perspective. The training seeks to reinforce the idea of “one family, one plan” by addressing Child and Family Teams through the lens of multiple systems as they affect families in their everyday lives. Agency representatives and parents/family members over 18 years of age are encouraged to attend this training.

Trainer: Jeanne Patterson, Child System of Care Liaison, Partners

Child and Family Team 2 Team Training (Registration)

Date, Time and Location:  April 29 and 30, 2019, 9:00 a.m. to 5:00 p.m., Gastonia

Description:  **Prerequisite required: CFT 1
This two-day course will prepare participants to facilitate Child & Family Team meetings across systems. This training offers a combination of reflective activities & practice skills needed to effectively facilitate CFT meetings.

**When you sign up for this training, you agree to attend both days

Agency representatives, & parents/family members over 18 years of age encouraged to attend.

Trainer: Kim Rhoads, Child System of Care Liaison, Partners; Casey Pruitt, Family Lead

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:

March 8, 2019 – March Webinar; #J319-Verification of Education; Rutherford Provider Forum; Psychological Testing Codes

March 18, 2019–Request for Proposals (RFP) Comprehensive Substance Use Services (RFP #0319-002)

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

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

NCTracks Reminders

Providers are reminded to visit https://www.nctracks.nc.gov/content/public/providers.html frequently for the latest news from NCTracks. You can sign up for emails from NCTracks by visiting https://www.nctracks.nc.gov/content/public/providers/getting-started.html.

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.

Training, Announcements, and Reminders

Partners June Provider WebinarPartners will host its next Provider Webinar on Wednesday, June 12 from 1 p.m.-3 p.m. Registration will open in April. To view past webinars, slide decks, and handouts, please visit https://providers.partnersbhm.org/provider-webinars-forums/. Please contact Roanna Newton at 828-323-8054 or email rnewton@partnersbhm.org with any questions.

Partners Gaps and Needs Survey Now OpenPartners Behavioral Health Management is responsible for the following quality assurance measures of behavioral health services for our members:

  • Ensuring service coverage for the catchment area
  • Ensuring services are accessible
  • Ensuring individuals have choices
  • Addressing the needs of underserved and special populations
  • Meeting community stakeholders’ needs

To achieve this task, Partners annually seeks input from a variety of sources (consumers, community stakeholders, and providers) via the Gaps and Needs Analysis Survey. We need input from every person and every perspective to find out what people think about the accessibility of services for mental health needs, substance use issues and intellectual or developmental disabilities in their local communities. Please take five minutes to complete our 2019 Community Needs and Gaps below.

Partners’ Provider CouncilPartners’ Provider Council will meet on Friday, March 22, 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 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. All providers are welcome to attend Provider Council meetings. To learn more, please visit https://providers.partnersbhm.org/provider-council/.

Partners Licensed Independent Practitioner Collaborative:  The Licensed Independent Practitioner (LIP) collaborative was developed to improve communication between Partners and Licensed Independent Practitioners. Meetings are held quarterly via conference call or webinar.

Date & Time: Wednesday, March 27, 2019 from 12:00 p.m. to 1:00 p.m.
Registration: Click Here to Register

View information from past meetings at https://providers.partnersbhm.org/licensed-independent-practitioners-collab/. If you have questions, please contact Maria Ballard at mballard@partnersbhm.org or call 704-884-2607.

Mandatory Provider Meeting for RFP 0419-003 (High Fidelity Wraparound)Partners is initiating a Request for Proposal (RFP) to identify current Partners’ Network Providers interested in and qualified to provide High Fidelity Wraparound (HFW) services for persons from birth through age 21 years of age, with a diagnosis of Severe Emotional Disturbance.  The location for services is within Partners catchment area, targeting Burke and Iredell Counties. Interested providers shall have the capacity to expand HFW in additional Partners’ counties, as service needs arise.  To learn more, visit Partners’ Request for Services webpage.

If you are interested in being considered for provision of these services with Partners, you must register to attend the Mandatory Provider Meeting to be held on Tuesday, March 26, 2019, from 10-12 am at Partners Behavioral Health Management, 1985 Tate Blvd SE, Multipurpose Room-Basement, Hickory, NC. Click here to register. Registration closes March 22, 2019 at 5:00 p.m. To be considered for provision of this service, you must attend the Mandatory Provider Meeting.  The RFP will be released on April 12, 2019.  At that time, organizations who attended the Provider Meeting are eligible to submit a proposal for this RFP.  The submission must follow the required RFP format and be submitted by Monday, April 29, 2019, by 5:00 pm to be considered.

Foothills Veterans Stand Down:  This year’s Stand Down will be held April 12, 2019, from 9 a.m.-2 p.m. at Catawba Valley Community College, Tarlton Complex, 2550 US Hwy 70 SE, Hickory NC. This event provides a variety of services for veterans living in the Foothills region and Western North Carolina. To learn how you can volunteer or participate, visit www.foothillsstanddown.com or contact Teena Willis (twillis@partnersbhm.org, 828-323-8084) or Alice Horton (ahorton@partnersbhm.org, 828-323-8047.

Public Policy Changes Impacting System of Care for Children, Youth, and Families:  i2i Center for Integrative Health is presenting a comprehensive policy training examining the critical state and federal system changes impacting care for children, youth, and their families in North Carolina. This is an NC Division of MH/IDD/SAS training and will be held Thursday, March 28, 2019, from 9 a.m.-3 p.m. at Royal Banquet and Conference Center, 3801 Hillsborough Street, Suite 109, Raleigh, NC 27607. Registration is required; visit https://i2icenter.org/events/public-policy-changes-impacting-system-of-care-for-child-youth-families/ for registration links and agenda. If you have questions, please call 919-657-0580 or email info@i2icenter.org.

Spring Fling DanceDon’t miss the Spring Fling Dance for people 16 or older who are living with intellectual or developmental disabilities. The event is on Saturday, April 6, 2019 from 5-8 p.m., at Bethel Presbyterian Church, 19920 Bethel Church Rd., Cornelius, NC. The dance is completely free and a buffet dinner with BBQ sliders, chicken nuggets, veggie and fruit trays, sandwiches, cookies, brownies, chips and salsa, and more. All you need to do is to come eat, dance, and enjoy.  Please sign up online at www.bethel-pc.org/resources/forms/spring-fling-dance. For more information, contact Lisa Hunter at 704-491-7869 or lisarenehunter@gmail.com.

The 14th Annual Youth Violence Prevention Conference—Learning Under Lockdown:  Helping Kids Navigate a Post-Columbine World: Is it possible to make our schools safer and better prepared to respond to school shootings if they occur, while not unnecessarily contributing to heightened anxiety and stress levels in our students? This conference will examine this complex, but critical, question with the goal of equipping and empowering each of us to engage – wherever we can – in the difficult work of helping to make all our schools safer for all students.  This conference, hosted by Charlotte AHEC, will be held Friday, April 12, 2019, from 8 a.m.-4 p.m. at Friendship Missionary Baptist Church.  Registration is required, CEUs are available. For more details, visit https://www.charlotteahec.org/continuing-professional-development/event.cfm?eventid=57447.