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Provider News

This section provides quick access to operational information and the latest news affecting the Partners’ Provider Network

Provider Communication Bulletin #158

In This Bulletin: Holiday Closing Announcement SUD Treatment Providers Needed for Pregnant and Postpartum Women Partners’ Current Service Needs PDL and Pharmacy Prior Authorization (PA) Requests Avoiding Overpayment and Ensuring Compliance for BCBA IRIS Incident Reporting Reminders Claims Information Quality Management Updates Recent Provider Alerts State News and Updates Training Resource and Collaborative (TRAC) Community

Provider Alert: Guidance for Providers on Service Flexibilities

Issued: November 5, 2024 Partners Health Management is providing clarification for providers and/or Tailored Care Managers regarding specific service flexibilities. You can view the list of flexibilities for behavioral health and for physical health on Partners' Provider Knowledge Base. This alert is a follow up to an alert issued on Oct. 14, 2024, by Partners,

Provider Communication Bulletin #157

In This Bulletin: Hurricane Helene Updates Back-Up Staffing Flexibilities Complying with the Deficit Reduction Act IRIS Incident Reporting Reminders Claims Information Utilization Management Updates Recent Provider Alerts State News and Updates Training Resource and Collaborative (TRAC) Community Training Additional Events and Training PDF Version > Hurricane Helene Updates Partners Health Management is actively supporting six

Provider Alert: Supported Employment (IPS-SE) Update: 1915(i) and 1915(b)(3) Supported Employment/NC Core Individual Placement and Support

Issued: October 3, 2024 CORRECTED: October 11, 2024 No prior authorization is required for 1915(i) and (b)(3) Medicaid NC CORE IPS-SE. What is happening? Prior authorization is not required for 1915(i) and 1915(b)(3) Medicaid NC CORE IPS-SE. This change is effective Oct. 1, 2024. Members receiving services under I/DD or TBI will continue to receive

Provider Communication Bulletin #156

In This Bulletin: 2024 Perception of Care Survey Update New Grant Initiative for Direct Support Professionals Tailored Plan Member and Care Manager Information Now Available for Providers Partners’ Pregnancy Program Pyx Health Information Contact Information to Share with Members Human Rights Committee Members Needed Claims Information Utilization Management Updates Recent Provider Alerts State News and

Provider Alert: New Grant Initiative for Direct Support Professionals

Issued: Sept. 18, 2024 The North Carolina Division of Mental Health, Developmental Disabilities, and Substance Use Services is soliciting requests from providers to fund recruitment and retention initiatives that directly enhance overall direct support professionals (DSPs) job quality and job satisfaction. As part of Direct Support Professional (DSP) Recognition Week, DMH/DD/SUS has announced the DSP

Provider Alert: Reminder for Electronic Visit Verification Personal Care Services Providers

Issued: Aug. 22, 2024 Partners Health Management is reminding providers that only Personal Care Services (PCS) 99509 HA and 99509 HB are subject to Electronic Visit Verification (EVV) requirements. Partners utilized HHAeXchange (HHA) as the EVV vendor. Providers subject to EVV requirements must submit claims through EVV. What must providers do? Providers subject to EVV

Provider Communication Bulletin #155

In This Bulletin: 2024 Perception of Care Survey Annual Network Adequacy Report Identifies Service Needs Claims Information Utilization Management Updates IRIS Incident Reporting Reminders Recent Provider Alerts State News and Updates Training Resource and Collaborative (TRAC) Community Training Additional Events and Training PDF Version > 2024 Perception of Care Survey The annual Perception of Care

Provider Communication Bulletin #154

In This Bulletin: NC Innovations Waiver Renewal Approved July 1, 2024 Clinically Managed Residential Withdrawal Services Claims Information Provider Alerts State News and Updates Training Resource and Collaborative (TRAC) Community Training Additional Events and Training PDF Version > NC Innovations Waiver Renewal Approved July 1, 2024 The Centers for Medicare & Medicaid Services (CMS) approved