Provider News

Issued: September 7, 2023 On March 30, 2023, Utilization Management (UM) notified providers that Partners would authorize service dates only through the end of the NC Medicaid Direct eligibility period, September 30, 2023. In a Provider Alert (https://legacy.providers.partnersbhm.org/updates-to-partners-prior-authorization-process/), Partners stated that authorizations for the remainder of the request period and units starting October 1, 2023,

Issued: July 27, 2023 Important Information: Medicaid Termination The 2023 Consolidated Appropriations Act that was signed into law in December 2022 removes the continuous Medicaid coverage requirement from the COVID-19 Public Health Emergency. As of May 1, 2023, state Medicaid programs are no longer required to maintain continuous coverage for beneficiaries. This means states must

Issued: July 27, 2023 As previously announced in a Provider Alert issued on March 21, 2023, Partners implemented NC Medicaid Direct flexibilities to ease the administrative burden for providers. The flexibilities went into effect on the launch date for NC Medicaid Direct (April 1, 2023) and were to end on June 30, 2023. Partners extended

Issued: July 19, 2023 Due to Alpha+ processing issues, Partners is extending the July 25, 2023, checkwrite cutoff. The new processing cutoff date will be July 19, 2023, for both State and Medicaid claims. If you have questions, please contact our claims department by calling 704-842-6486 or emailing claimsdepartment@partnersbhm.org.

Issued: July 14, 2023 Reverification, also known as recredentialing, is an evaluation of a provider’s ongoing eligibility for continued participation in NC Medicaid. The Affordable Care Act requires that providers be reverified every 5 years to ensure their credentials and qualifications meet program requirements and are in good standing. Providers receive notice of their reverification

Issued: July 11, 2023 What is happening? The North Carolina Department of Health and Human Services (NCDHHS) has announced a change in the timeline for the launch of NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans that were scheduled to begin on October 1, 2023. Funding for the implementation of Tailored Plans

Issued: July 10, 2023 Attention 1915(b)(3) Providers: Launch of 1915(i) and Transition of 1915(b)(3) Codes Centers for Medicare & Medicaid Services (CMS) approved the 1915(i) State Plan Amendment (SPA) effective July 1, 2023. Like 1915(b)(3) services, 1915(i) services are home and community-based services (HCBS) which provide opportunities for Medicaid enrollees to receive services in their

Issued: June 23, 2023 As previously announced in a Provider Alert issued on March 21, 2023, Partners implemented NC Medicaid Direct flexibilities to ease the administrative burden for providers. The flexibilities went into effect on the launch date for NC Medicaid Direct (April 1, 2023) and were to end on June 30, 2023. Partners is