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Provider Alert

Provider Alert: Claims Information Related to NC Medicaid Direct Launch on April 1

Issued: March 22, 2023 Claims Information Related to NC Medicaid Direct Launch on April 1 Effective April 1, 2023, Partners Medicaid benefit plan will transition to NC Medicaid Direct. Partners is providing information on submitting professional and institutional claims. What is happening? Partners is clarifying how providers should submit professional and institutional claims on or

Provider Alert: Partners Implementing NC Medicaid Direct Flexibilities

Issued: March 21, 2023 Effective April 1, 2023, Partners Medicaid benefit plan will transition to NC Medicaid Direct. Partners is implementing NC Medicaid Direct flexibilities effective April 1-June 30, 2023 to ease administrative burden for providers.  What is happening? Partners is relaxing prior authorization requirements for NC Medicaid Direct services for dates of service April

Provider Alert: Clarification of Prior Authorization for Medicaid and State-funded Psychosocial Rehabilitation

Issued: March 15, 2023 What is happening? In the Provider Alert issued on February 16, 2023, Partners announced changes to the benefit limit for Psychosocial Rehabilitation (PSR). These changes were effective on Feb. 22, 2023 and apply to initial or concurrent requests for PSR. You can access the full article at https://legacy.providers.partnersbhm.org/provider-alert-utilization-management-prior-authorization-for-medicaid-and-state-funded-psychosocial-rehabilitation/  What do providers

Provider Alert: State Updating IRIS System on March 5

Issued: March 3, 2023 What is happening? The North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services and the Department of Information Technology will be updating the IRIS system on Sunday, March 5. The system will be unavailable for all users from 8 a.m. to 1 p.m. Sunday. What is the impact

Provider Alert: ProviderCONNECT and MemberCONNECT are Back Online

Issued: March 2, 2023 What is happening? After experiencing an outage on March 1, MemberCONNECT and ProviderCONNECT are back online. What is the impact to providers? This means providers can resume use of ProviderCONNECT to submit authorization requests through ProAuth. What if providers have questions? Providers may call the Provider Support Line at 1-877-398-4145, Monday

Provider Alert: NCDHHS Delays Implementation of Tailored Plans until October 1, 2023

Issued: February 27, 2023 What is happening? The North Carolina Department of Health and Human Services (NCDHHS) is delaying implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans (Tailored Plans) until October 1, 2023. What does this mean for providers? The delayed start of Tailored Plans will allow more time

Provider Alert: ILOS Changes for Behavioral Health I/DD Tailored Plan and NC Medicaid Direct

Issued: February 23, 2023 Effective April 1, 2023, Partners Health Management’s In Lieu of Service (ILOS) will be transitioned to the Behavioral Health I/DD Tailored Plan (Tailored Plan) and/or NC Medicaid Direct or discontinued. On March 9, 2023, Partners will host a virtual information session for providers from 2 to 3 p.m. to share more

Provider Alert: Utilization Management: Prior Authorization for Medicaid and State-funded Psychosocial Rehabilitation

Issued: February 17, 2023 Utilization Management: Prior Authorization for Medicaid and State-funded Psychosocial Rehabilitation Effective February 22, 2023, the following changes will be made to the benefit limit for Psychosocial Rehabilitation (PSR). This applies to both initial and concurrent requests for PSR. Changes have been made to facilitate claims with the new system, TruCare. Partners Utilization

Provider Alert: PartnersACCESS Call Center Updates

Issued: February 14, 2023 PartnersACCESS Call Center Updates Partners is excited to announce new enhancements to our PartnersACCESS Call Center. This includes: An Interactive Voice Response System (IVR) with prompts to easily reach departments and topics at the touch of a button. Selections offered in English or Spanish. A new menu with options for Providers