Provider Alert

Issued:  June 5, 2019 The next AlphaMCS build is scheduled to occur today.  It is anticipated that the system will be unavailable from 5:00 p.m. – 7:00 p.m. We apologize for the late notice.  Please make sure you are logged out of the AlphaMCS system prior to 5:00 p.m. If you have any questions, please

Issued:  May 16, 2019 NC Medicaid Managed Care Training Courses  The Division of Health Benefits is hosting a series of webinars that offer a high-level overview for providers of the transition to NC Medicaid Managed Care.  Upcoming courses are listed below; providers can view previous webinars or register for future webinars at https://medicaid.ncdhhs.gov/nc-medicaid-managed-care-training-courses.  TODAY - MCT 105: Beneficiary Policies

Issued:  May 6, 2019 Exception to Benefit Plan Limits for Inpatient Services Partners Utilization Management (UM) allows a maximum of three days to be requested for all Medicaid (0101) and State-funded (YP820) Inpatient Service Authorization Requests (SARs). Effective June 20, 2018, Partners began allowing an exception for SARs with a length of stay covering weekend

Issued:  April 29, 2019 Utilization Management Update: Unmanaged Units for Outpatient Behavioral Health Services In years past, Service Authorization Requests (SARs) submitted in AlphaMCS for Outpatient Behavioral Health Services that extended into the new fiscal year on July 1, 2019 automatically forfeited the unmanaged visits. Effective immediately, Outpatient Behavioral Health Providers no longer need to

Issued:  April 24, 2017 The next AlphaMCS build is scheduled to occur today, Wednesday, April 24, 2019. The system will be unavailable from 5:00 p.m. – 9:00 p.m. Please make sure you are logged out of the AlphaMCS system prior to 5:00 p.m. If you have questions, please contact Partners IT Service Desk at 704-842-6431.

Issued: April 22, 2019 Request for Proposals – High Fidelity Wraparound Partners initiated 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 on February 21, 2019 (Provider Communication

Utilization Management Update:  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 or not. For all other

Issued:  March 27, 2019  The next AlphaMCS build is scheduled to occur today, Wednesday, March 27, 2019.  The system will be unavailable from 5:00 p.m.-9:00 p.m.  Please make sure you are logged out of the AlphaMCS system prior to 5:00 p.m.  Included in this build:  Patient Maintenance>Patient Filter screen:  Insurance # field will now allow search by Medicaid #  Enrollments>Create>Patient Search

Issued: March 26, 2019 Claims Processing Edit Currently, there is not an edit that checks to see if the PR (Patient Responsibility) field has a value or not on an 837P with a COB (Coordination of Benefits). Due to not having an edit in place, the claim will not deny and process through adjudication. Beginning Thursday,

Issued: March 18, 2019  Partners is 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