Rutherford Transition Information

Issued:  July 1, 2019

Providers are reminded that Partners communicates essential operation info through the Provider Communication Bulletin and Provider Alert.
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Locating a Rutherford Member in Partners’ AlphaMCS

When searching for a Rutherford County member the first time in the Partners’ AlphaMCS database to create an Enrollment, Client Update Request (CUR), Service Authorization Request (SAR), etc., please remember that you will need to search for that member by using three pieces of identifying information.  Since there are no existing SARs, CURs, claims, etc. for these members in the Partners’ database, the system does not recognize that you have previously provided services for Rutherford County members.

Please use one of the following search options:

  • Last Name, First Name, Date of Birth

OR

  • Last Name, First Name, Social Security Number

If you follow these steps and are unable to locate the member, please check NCTracks to verify if the member has Medicaid.

  • If the member is enrolled in Medicaid, please call Partners IT Service Desk at 704-842-6431.
  • If the member does not have Medicaid, you will need to complete an enrollment form.

Service Authorization Requests for Rutherford Members

Thank you to all providers who have submitted information requested by Partners per Provider Communication Bulletin #94 and the June 24, 2019 Provider Alert.

As stated in the June 24, 2019 Provider Alert, Partners has been given information (from Vaya Health) about all authorizations that have been issued up to June 30, 2019.

  • If you had an authorization through Vaya with an end date beyond June 30, 2019, you do not need to submit a new SAR. Partners will honor the SAR through the approved end date.
  • If you had an authorization with a requested end date beyond June 30, 2019, but Vaya end-dated the SAR on June 30, 2019, you do not need to submit a new SAR. Partners will honor the SAR through the requested end date.

Providers only need to submit a SAR if:

  • You need to submit a new SAR for a service that has not been previously requested for the member (i.e. a new service)
  • You would have needed to submit a re-authorization of the service due to an original requested end date of June 30, 2019
  • You are contacted by Partners
  • If you are authorized by Partners for an end-date of July 1, 2019 or later, you would need to submit a new SAR for Medical Necessity Review

If you have further questions, please contact Partners’ Utilization Management:

  • IDD/Innovations Utilization Management Questions:  704-884-2605
  • MHSU Utilization Management Questions:  704-842-6436