2019 Perception of Care Survey

Each year the North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (NC DMH/DD/SAS) oversees the administration of the annual Perception of Care  Survey to individuals participating in treatment for substance use and/or mental health disorders. The survey complies with requirements from the Federal Community Mental Health Services Block Grant and the Substance Abuse Prevention and Treatment Block Grant. This survey assesses the consumer’s perceptions of the quality of care and services they have received in the past year. Survey results are reported to the Substance Abuse and Mental Health Services Administration (SAMHSA) by NC DMH/DD/SAS and published by LME-MCOs in an annual report.

Partners’ QM Monitoring Specialists will contact selected mental health and substance use providers with information for administering this year’s Perception of Care Survey. View Survey Administration Guidelines. The survey period begins Monday, May 6, 2019 and will end Tuesday, June 4, 2019. All surveys need to be returned to Partners before Friday, June 7, 2019.

Providers can return the surveys to Partners in the following ways:

  • contact your QM Monitoring Specialist for pick-up; or
  • send/deliver to April Corder at Partners’ Corporate office, 901 S. New Hope Road, Gastonia, NC

Please direct requests for additional surveys, surveys in Spanish, or any other questions regarding this year’s survey implementation to April Corder at 704-884-2591, acorder@partnersbhm.org or to Bill Rankin at 704-884-2688, brankin@partnersbhm.org.

Partners expresses its gratitude for your assistance in administering the 2019 Perception of Care survey.

Partners Welcomes Rutherford

Meet and Greet
Partners invites members, their families, and caregivers to learn about our services.

Mental Health and Substance Use Services

April 24, 2019, 5:30 p.m.-7:30 p.m.

Rutherfordton Regional Hospital – Norris Biggs Conference Room
Utilize outpatient/admitting entrance
288 S. Ridgecrest St. Rutherford, NC 28139
This event is free and open to the public. Dinner will be provided.

Register nowhttps://is.gd/partners424

As a member, your voice is important to us. The Partners team wants to know:

  • What are your needs?
  • What do you want from your health plan?
  • How can Partners help you?

Partners also wants to share important information on accessing care, including:

  • Where do I go or who do I call if I am looking for help?
  • What services are available to me and which providers will deliver them?
  • What is care coordination and how can that help me?
  • What if I need help with housing, transportation, utilities, or medication?
  • What if I have a problem or complaint that needs attention?
  • How can I get involved so my voice can be heard?

Intellectual and Developmental Disability Services

April 30, 2019

Two opportunities to attend:

2:00 p.m. – 4:00 p.m. or 5:30 p.m. – 7:30 p.m.

Register Now: https://is.gd/partners430 

Isothermal Community College – The Foundation Performing Arts Center
286 ICC Loop Road Spindale, NC 28160
This event is free and open to the public. Refreshments will be provided.

Come join Partners’ staff on April 30 to learn about our IDD services and what you can expect after the transition, effective July 1, 2019. The presentation will begin at 2:00 p.m. and will be repeated at 5:30 p.m.; our staff will be on site to answer questions following each presentation.

Technical Extension of North Carolina’s 1915 (b) Waiver and Concurrent 1915 (c) Innovations Waiver

The Centers for Medicare & Medicaid Services (CMS) granted North Carolina a technical extension (TE) of North Carolina’s 1915(b) waiver program and the concurrent 1915(c) Innovations waiver until June 27, 2019.

CMS has suggested that the new waiver start on July 1, 2019. NC Medicaid will submit as second TE to CMS to cover June 28, 2019 through June 30, 2019, as a TE can only be requested for 90 days. Medicaid continues to work with CMS towards the renewal of the waiver.

For current participants, the NC Innovations Waiver will continue to operate at cost and utilization levels approved for the fifth year of the waiver. The NC Innovations Individual Cost Limit of $135,000 per year will continue to reset with the participants approved annual Individual Support Plans. CMS is granting North Carolina this extension to review the waiver renewal applications and to align the waiver effective dates with federal fiscal year quarters.

Authorizations for services that have ‘Life of the Waiver’ financial limits (Home Modifications, Vehicle Modifications, and Assistive Technology) may not exceed those limitations. Once the waiver is renewed, those limits will start over.

If you have any questions, please contact Kenneth Bausell at 919-527-7643 or email Kenneth.Bausell@dhhs.nc.gov, or contact Deb Goda at 919-527-7640 or email Deborah.Goda@dhhs.nc.gov.

Providers with Partners-specific questions should contact Tammy Gilmore at 704-884-2597 or email tgilmore@partnersbhm.org.

NC HealthConnex Updates

IMPERATIVE THAT YOU STILL WORK TO CONNECTIn order to comply with NC General Statute 90-414.4, that defines the required timing for provider data transmission to the North Carolina Health Information Exchange Authority (NC HIEA) (also referred to as NC HealthConnex), all Partners providers must connect to NC HIEA by June 1, 2019 to continue to provide Medicaid and State-Funded billable services.

Please click the link for more information: https://www.ncleg.net/EnactedLegislation/Statutes/PDF/BySection/Chapter_90/GS_90-414.4.pdf

If the June 1, 2019 date is not extended by the State, any provider that does not have an EHR in place and is not connected to NC HealthConnex will no longer be eligible to bill for Medicaid and State funded billable services.

To initiate the NC HIEA connection process, learn more about EHR system requirements, or learn more about the time requirements and other NC HIEA details, please visit this link:  https://hiea.nc.gov/providers/how-connect

Per NCGS § 90-414.4 (a2) the NC HIEA, in consultation with the Department of Health and Human Services (DHHS), has established a process to grant limited extensions of the time for providers and entities to connect to NC HealthConnex and begin submitting data as required by law.

The NC HIEA and DHHS understand that many health care providers will not be able to connect to NC HealthConnex by the mandated deadlines. The General Assembly has permitted the NC HIEA and DHHS grant extensions to health care providers if they can meet certain criteria. Any organization that is not live and is affected by the June 1, 2018 deadline will automatically receive an extension once they have an executed Participation Agreement on file.

If you recently submitted your Participation Agreement and fall under the June 1, 2018, deadline, you will receive notice of your approved extension when your executed Participation Agreement is returned to you. There is no need to submit an extension form.

Due to the recent volume of agreements submitted, please allow two to four weeks to receive your executed agreement. As long as you have submitted a Participation Agreement, your Medicaid reimbursements will not be adversely affected.

Important Information

  • Participants who are in the queue to connect and are moving forward in the technical process, will automatically receive an extension and remain in compliance.
  • New participants who are mandated to connect by June 1, 2019, will automatically receive an extension if they are still in the queue to connect on their deadline.

Please note: Participants must remain responsive with the NC HealthConnex technical team and continue to move forward in the connection process. The extension is not a waiver, but simply an extended period of time to finish the connection build.

  • All health care providers must connect to NC HealthConnex by June 1, 2020, as required by law, so no extension deadlines will be set beyond June 1, 2020.
  • This process is not a request for a waiver/exemption from the state’s requirements, but an extension of time to meet the state’s requirements. It simply allows more time for the technical onboarding to occur to be in compliance with the HIE Act.

New Platform for NC HealthConnex Launched in April:  Beginning in April, participating health care providers in the state-designated health information exchange (HIE), NC HealthConnex, will be moving to a new HIE platform.

Current participants of NC HealthConnex will be moved to the new platform using a phased approach with a target date of April 18, 2019, for completion. Training materials are available on the NC HIEA website and were distributed via email to Participant Account Administrators (PAAs).

The NC HIEA will host three Teletown Hall webinar trainings on the new system in April and May. Participants may register on the nchealthconnex.gov website.

As a reminder, work on connecting new participant systems to NC HealthConnex is currently paused until late April. This pause does not impact compliance with the HIE Act as the extension process is in place. The NC HIEA will be in touch with each new participant regarding connection schedules, applicable training or other user needs.

Participants should stay tuned to their inbox for emails regarding training opportunities and transition dates specific to their organization.

For questions relating to NC HealthConnex, please reach out to provider relations at hiea@nc.gov or call 919- 754-6912. To learn more about NC HealthConnex and the connection process, please join the next How to Connect call.

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

noted on the Claims Department webpage, https://providers.partnersbhm.org/claims-information/.

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—March 2019:   Number of Days to Process and Pay All Claims
Received Date to Paid Date: 8.7
Top Five Medicaid Claim Denials—March 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.
Invalid DCN (Document Control Number) or Resubmission Reference Number Review the RA (Remittance Advice) with the original claim number and make sure it was entered correctly.
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.
Duplicate Claim The claim has previously been submitted and adjudicated. Do not refile.

Provider Monitoring? Program Integrity? What’s the Difference?

What’s the difference between Partners Quality Management Monitoring (QMM) and Program Integrity Department (PID) activities?

Partners’ contract with the North Carolina Department of Health and Human Services (NCDHHS), Department of Health Benefits (DHB) requires it to establish and implement a program integrity department. PID is responsible for the identification, detection and prevention of fraud, waste, and financial abuse (FWA) in Partners’ Provider Network, in accordance with Partners’ contract with DHB and federal and state laws and regulations. PID carries out its responsibilities through the conduct of audits and investigations of allegations of FWA.

An additional contractual requirement is that Partners’ Quality Management Monitoring (QMM) perform provider monitoring once every two years on each of the contracted providers within its network.

What happens during a provider monitoring?

QMM performs its monitoring activities using DHB’s Monitoring Tools and Guidelines. A monitoring is an overall look at a provider’s services and the State’s tools/guidelines dictate the elements reviewed. Once complete, a provider receives an automatically computed score that is based on the review’s findings. A score below 85, results in a plan of correction (POC). A POC may also be issued for any systemic issue discovered. An example would be a provider with an overall score above 85 but has one item on the tool where it did not score meets for any of the claims reviewed. The POC is used to ensure the provider takes actions to correct the deficiency and to avoid future findings of non-compliance.

Why did I get an overpayment notice after a plan of correction?

Correction of mistakes through POCs and repaying improperly paid claims are separate actions. PID’s work may be a continuation of QMM’s findings. POCs help to ensure that providers take corrective measures to avoid future findings of non-compliance. Correcting the non-compliance is just one step in the process.

Partners’ is required by contract, law, and regulation to recover improperly paid claims.

No really, why does Program Integrity need to be involved after I received a POC sanction?

The requirement that providers must implement strategies to correct areas of non-compliance with the laws, regulations and rules is not punishment. Some items on the monitoring tool require referral of non-compliant issues to Partners’ PID, which is in addition to a POC. For example, if there are only one or two items that appear to require a payback, QMM will request the POC and that the provider pay back the identified claims and show evidence of payment—which can be done through a self-audit. If QMM discovers numerous areas of non-compliance that may require payback, it makes a referral to PID. It in turn conducts a review of QMM’s findings and determines if it needs to look at additional items to confirm if payback is warranted. Once QMM makes a referral to PID, QMM is no longer involved in PID’s process.

What does Program Integrity do with the information it receives following a provider monitoring?

PID is responsible for the identification, detection and prevention of FWA in Partners’ Provider Network, in accordance with Partners’ contract with DHB and federal and state laws and regulations. PID carries out its responsibilities through the conduct of audits and investigations of allegations of FWA, some of which come from QMM. Any substantiated allegations may result in a referral to DHB (if potential fraud is discovered), issuance of a tentative notice of overpayment (TNO), issuance of a warning letter, and/or other appropriate internal or external referral or sanction.

Why did I get a TNO?

When PID identifies an improperly paid claim to a provider, a TNO is issued to that provider. A claim is considered improperly paid if it and/or the supporting documentation is not in accordance with law, regulation, rule, and/or policy. On the other hand, a warning letter may be used if the amount of claim(s) subject to repayment is less than $150 or if the violation would be unsustainable during appeal. In some instances, PID may issue both warning letters and TNOs. This occurs when areas of non-compliance are identified and subject to payback, as well as other areas not subject to payback are found. Both TNO’s and warning letters are designed to notify providers of non-compliance, so they will implement corrective action to avoid future violations.

Why does Partners have to recover overpayments for services the consumer received?

The United States Department of Health and Human Services, Centers for Medicare and Medicaid Services has imposed requirements on the State of North Carolina, which are in turn imposed on Partners through its contract with NCDHHS-DHB. One of those requirements is that all identified overpayments be recovered from providers.

Utilization Management Updates

(this information was also shared in a Provider Alert released on April 11, 2019) 

Notification regarding Service Authorization Requests (SARS) and Pass-throughs:  AlphaMCS is now allowing providers to bill for their pass-through period for certain services without a Notification SAR. Effective April 3, 2019, SACOT and SAIOP providers may choose to request a Notification SAR to cover their pass-through period. For all other services that have a pass-through, a Notification SAR is required.

Service Code “All Services” Tied to Definition Outpatient Individual Therapy Now Functioning Correctly:  AlphaMCS is now allowing authorizations to be processed with outpatient codes associated with the service code “All Services”. All Services corresponds with the Outpatient Individual Therapy definition in AlphaMCS. You may begin requesting authorizations for service code “All Services” effective April 3, 2019.

If you have any additional questions, please contact the Mental Health/Substance Use (MHSU) UM Workgroup at 704-842-6436.


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.

NEW! Early Childhood Trauma 101 & Evidence-Based Treatments (Registration)

Wednesday, May 1, 2019, 1:00 p.m. – 2:30 p.m., Online Webinar

Description: This 90-minute webinar will explore what we know about how attachment and trauma impact one another as children develop in the first five years of life. The webinar will then explore three-evidence based mental health interventions that counteract some of the deleterious effects of trauma on the development of young children using the crucial primary attachment relationship. The presenter will briefly describe Attachment and Bio-behavioral Catchup, Parent Child Interaction Therapy, and Child Parent Psychotherapy, and how each model is trained at the Center for Child and Family Health and North Carolina Child Treatment Program.

Target Audience: Clinicians and/or agencies providing mental health treatment to children birth – 6 years old, and their families

Trainer: Donna Potter, LCSW, Instructor, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Senior Clinical Faculty Consultant, North Carolina Child Treatment Program, Center for Child and Family Health

NEW! Provider Orientation

9:00 a.m. – 12:00 p.m., Gastonia: May 2, June 6, August 1, September 5, or October 3 (click a date to register)

Description: Join Partners’ Provider Network, Claims, Access to Care, Utilization Management, Care Coordination, and Quality Management staff for an interactive provider orientation. These open-house style events will allow attendees time to work one-on-one with Partners’ staff to discuss any issues or unfamiliar topics. Participants are encouraged to bring their own laptops to access and review their specific workflow.

These sessions will reoccur monthly on the first Thursday of each month from May – October 2019 (excluding the month of July due to the Independence Day holiday).

These training sessions are open-house style with no formal presentation or start time. 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 these orientations is not limited to only providers who are new to Partners’ network, but it is advised that attendees already have access to AlphaMCS prior to attending a session.

Person Centered Planning/Documentation (Registration)

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

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

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

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:

“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 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

Youth Mental Health First Aid Hosted by Oak Hill United Methodist Church (Registration)

Date, Time and Location:  Tuesday, May 7, 2019, 8:30 a.m. – 4:30 p.m., Oak Hill United Methodist Church – Fellowship Hall, 2239 NC 181, Morganton, NC 28655

For more information, call Kim Rhoads at 828-323-8049 or email krhoads@partnersbhm.org

*Must be at least 18 years of age to take this training (Deadline to register is Friday, May 3, 2019)

Independent Living Nutrition Classes

Obtaining and maintaining housing is a vital part of the lives of our consumers. If they haven’t been able to experience independent living before, there are some aspects that may become overwhelming. Learning to prepare and eat nutritious meals can be one of those challenges. Learning to plan meals and purchase the correct foods are equally as important as learning about caloric intake recommendations. Partners is collaborating with N.C.  Cooperative Extension to offer nutrition classes for our consumers to overcome these challenges. Our next class will be at the Cooperative Extension Office at 444 Bristol Drive, Statesville, NC on May 30, 2019 from 11:00-12:00. For registration, contact Bre Griffin, Housing Educator, at 704-884-2514 or bgriffin@partnersbhm.org.

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:

April 11, 2019:  Utilization Management Updates
March 27, 2019:  AlphaMCS 2.10 Build
March 26, 2019:  Claims Processing Edit; Submitting Update Requests; Discharge Reminders

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

This month’s bulletins:

#J322 2019 Behavioral Health CPT Code Changes for Psychological Testing Changes

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

NCTracks Reminders

Provider Transition to Medicaid Managed Care – Additional Webinar Topics AnnouncedNC Medicaid recently launched a webinar series to support providers and practices during their transition to NC Medicaid Managed Care. “General” webinars are overviews of significant changes and features of the managed care program. “Topical” webinars are in-depth reviews of specific managed care topics. View all the topics here.

New Special Medicaid Bulletin, Provider Training Opportunity: Provider Transition to Medicaid Managed Care 101The NC Division of Health Benefits has published a Special Medicaid Bulletin, Provider Training Opportunity: Provider Transition to Medicaid Managed Care 101, dated March 2019. Providers are encouraged to review this important information. For details, please refer to the 2019 Medicaid Bulletin web page.

NCTracks Provider Training Available in April 2019Registration is open for the April 2019 instructor-led provider training courses. For the course schedule and registration instructions, see the announcement.

Importance of Updating Provider Record Correspondence Address: Returned Mail and Provider Suspension: It is crucial for providers to keep their records updated with the correct mailing address for written correspondence. If it is not current, problems may arise, including potential suspension of the provider record. All providers are advised to check their records now and update their correspondence address if it is inaccurate. Learn more

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.  Click here to register. 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 Autism Collaborative Autism Services Learning Collaborative: Partners offers 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 April 24, 1:30 p.m.-3:30 p.m., Partners’ Auditorium, 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 in order to promote positive outcomes for children diagnosed with Autism.
  • 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.

Partners’ Provider Council:

Partners’ Provider Council will meet on Friday, April 26, 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 representation of the network 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/.

Benchmarks’ Public/Private Behavioral Health Forum

The meeting will be held on Friday, May 3, 2019 from 10:30 am to 2:30 pm at Royal Banquet & Conference Center, 3801 Hillsborough Street, Raleigh, NC. (Located directly across the street from Meredith College, parking is in the rear of the building.)

Join us to receive the most recent legislative updates, information from DHHS and more.

Topics will include (but are not limited to):

  • DHHS Updates for Medicaid Reform:
  • Standard Plans;
  • Tailored Plans;
  • 1115 Waiver Updates;
  • Healthy Opportunities News and Updates;
  • Projected Timelines for Implementation.

The afternoon session will include a panel of Private Managed Care Organizations, such as Benchmarks’ Affiliate Members AmeriHealth Caritas, Carolina Complete Health, HealthyBlue, UnitedHealthcare Community Plan and Wellcare to discuss their vision of the future around the following topics:

  • Behavioral providers and the Standard Plan;
  • Contract negotiating;
  • What are private managed care companies looking for from service providers;
  • Vision for the future;
  • What should providers be doing now to be best prepared;

Registration Information:  Cost:  $30 for Benchmarks’ members (please contact Paige Wiggs for promotional code), $45 for non-members (Lunch is provided)  Click here to Register.

You will be asked to list potential questions you would like addressed as part of the discussion during the registration process.  The responses will be tallied, and if time allows, we will address the most common themes.

i2i Spring Conference—Registration Now Open!  The i2i Spring Conference will be held June 10-11, 2019 at the North Raleigh Hilton in Raleigh, NC. View the Conference Brochure. To learn more and access the registration link, click here.

Mind Fest:  NAMI of South Mountains is sponsoring Mind Fest, an event focused on mental health awareness, on May 18, 2019 from 11 a.m.-3 p.m. at Spindale House, 119 Tanner Street, Spindale, NC 28160.  Learn more:  https://namirutherfordclevelandburke.org/.