Provider News

Issued: March 31, 2023 What is happening: The Centers for Medicare & Medicaid Services (CMS) has approved an amendment to the NC Innovations Waiver to add additional waiver slots to transition the 1915 (b)(3) Deinstitutionalization services (NC Innovations-look alike services) into the NC Innovations Waiver effective April 1, 2023. How is this impacting members? Members

Issued: March 30, 2023 Effective April 1, 2023, Partners Medicaid benefit plan will transition to NC Medicaid Direct. The Tailored Plan eligibility start date has changed to October 1, 2023. What is happening: Partners is authorizing service dates only through the end of the current NC Medicaid Direct eligibility period, September 30, 2023. When is this happening: The

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

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

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

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

Issued: March 1, 2023 What is happening? Partners secure member and provider portals are experiencing outages. Both MemberCONNECT and ProviderCONNECT are off line. We are working to resolve the issue as quickly as possible and will let you know when the portals are back on line. What is the impact to providers? This means providers

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

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

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