Partners’ Annual Provider Forum
Partners has had a great response for the upcoming Provider Forum on March 14, 2018! At this time, registration is full, however, if you would like to be added to the wait list, please contact Roanna Newton by emailing rnewton@partnersbhm.org or calling 828-323-8054.
In addition, if you have registered for the event and will not be attending, please let us know by emailing questions@partnersbhm.org so others on the waitlist can be invited to attend in your place.
To view the schedule and list of speakers, please visit https://legacy.providers.partnersbhm.org/annual-provider-forum/.
Save the Date! Partners Health Summit: Treating the Opioid Crisis
Learn about local solutions and treatments for North Carolina’s opioid epidemic at this free education conference, sponsored by Partners.
When: April 6, 2018, 8 a.m.-4 p.m.
Where: Hickory Metro Conference Center, 1960 13th Avenue Drive SE, Hickory, NC 28602
Admission is FREE. Continuing Education Units will be available. To learn more, visit https://www.partnerstraining.org/treating-opioid-crisis/.
Provider Contracting
As the NC Department of Health and Human Services moves toward restructuring its 1115 Medicaid waiver model, a number of potential payers appear to be anticipating the need to establish a NC behavioral network. It is possible that you have been or will be contacted by them. The decision whether or not to join these networks is something each provider will need to make for themselves as successful bidders begin an implementation process. This will occur sometime in the future according to a timeframe that has yet to be determined by the state.
However, please know that to date, nothing has changed in Partners’ current system serving Medicaid enrollees. We continue to be fully responsible for our provider network and contracted services. Rest assured that Partners will be in close communication with all stakeholders as our NC Medicaid system continues to evolve, potentially impacting our established system of care.
If you have further questions or comments, please email them to questions@partnersbhm.org.
You are invited! Global Continuous Quality Improvement Committee
Providers are invited to participate on Partners’ Global Continuous Quality Improvement (GCQI) committee. This open committee is a subgroup of Partners’ Provider Council and focuses on quality improvement. This is a perfect opportunity for providers to discuss and work on goals for both mental health/substance use and intellectual and developmental disabilities services being provided. This committee is currently held every first Friday of the month except for January and July. It is held at the Partners Hickory office in the Basement Multipurpose Conference room.
We all want consumers to have the best quality services that will also strengthen our communities. With that common goal in mind let’s partner up and discuss areas of improvement that will have the best positive impact on our consumers and communities!
Our next meeting is scheduled for March 2, 2018 at 9:30 a.m. Packet information is sent out to the committee prior to the meeting for the purpose of printing ahead of time and having the necessary information to come to the meeting with solutions related to the agenda items. If you have questions or would like to be part of Global QIC, please forward any questions to Tamikka Woods, (twoods@partnersbhm.org).
Provider Operations Manual Update
The Partners Provider Operations Manual has been revised and is available for download at https://legacy.providers.partnersbhm.org/orientation-packet-provider-operations-manual/.
Benefit Grids Update
Updated benefit grids for Medicaid, B3, and State-Funded services are posted to the Provider Knowledge Base at https://legacy.providers.partnersbhm.org/benefit-grids/. Questions should be directed to Lynne Grey, Utilization Management Manager, at lgrey@partnersbhm.org.
Claims Information
Providers are reminded to use the email Claims_Department@partnersbhm.org for all email inquiries so that they are handled in the most efficient manner. Please do not send email directly to individual employees.
AlphaMCS Portal University is an available resource and guide for navigating AlphaMCS. If you need additional claims training, please contact Rhonda Colvard by email (rcolvard@partnersbhm.org) to schedule a time for training.
| Medicaid—January 2018
Number of Days to Process and Pay All Claims |
|
| Received Date to Paid Date: | 8.7 |
| Top Five Medicaid Claim Denials—January 2018 | |
|
Claim Denial |
Provider Recommended Action Steps |
| The procedure code/bill type is inconsistent with the place of service | Contact Claims Department. |
| Claim received after billing period | Write off charges as non-billable. Do not rebill. |
| Duplicate Claim | Claim has previously been submitted and adjudicated. Do not refile. |
| Billing Taxonomy submitted is not associated with the Billing NPI | Resubmit claim with a valid taxonomy. |
| Service is not authorized | Verify Service Authorization for consumer. Contact Utilization Management. |
Timely Filing Override Requests: Please make sure claims are being submitted according to the timely filing guidelines. If claims deny for any of the reasons below, make sure you submit timely filing override requests within the time frames below.
Timely filing override requests should only be submitted for the following reasons. All requests are reviewed for consideration.
- Retroactive Medicaid: Claims based on retroactive Medicaid eligibility must have authorization requested within 30 days and submit claims within 90 days of the date modified in NCTracks for eligibility date range. Claims Department should be contacted prior to submitting claims.
- Retroactive Medicare/TPL: If claims are recouped due retroactive Medicare/TPL, the claim can be resubmitted once the claim has been resubmitted to other insurance. The only exception is claims that are not within the Fiscal Year for State benefit. Please resubmit within 90 days of the recoupment.
- License update/addition: Request must be submitted within 30 days of the update or addition.
- Site update: Request must be submitted within 30 days of update or addition.
- AlphaMCS system issues identified by Partners
- Eligibility issue with NC Fast/NC Tracks: Request must be submitted within 30 days of date modified in NCTracks.
Timely Filing Requests should be sent to claims_department@partnersbhm.org prior to submitting the claims.
Questions about Incidents and IRIS? Here’s who to call
Although Partners has requested a waiver for submission of the Quarterly Level I Incident Report, there are times that providers may need to reach Partners’ employees regarding other types of incidents. Here’s who you need to contact:
| For: | Contact |
| Level III Incident Reporting | Kim Miller, phone: 704-884-2515, email: kmiller@partnersbhm.org |
| Level II Incident Reporting | For incidents in Cleveland, Gaston, or Lincoln:
Kim Miller, phone: 704-884-2515, Bonnie Stanifer, phone: 704-884-2519, For incidents in Burke and Catawba or Out-of-State PRTF providers: Rodney Harris, phone: 704-884-2624, For incidents in Iredell, Surry, or Yadkin: Keshia Sandidge, phone: 704-884-2698, email: ksandidge@partnersbhm.org |
Positive Trends: Home and Community Based Services Standards
Over the coming months, members of Partners’ Intellectual and Developmental Disabilities Monitoring Team will be sharing some of the trends they have seen that promote self-determination and compliance with Home and Community Based Services (HCBS) standards. Here is an article from Hiram Harrington, Monitoring Specialist, IDD Care Coordination:
Partners I/DD Monitoring Specialists are expected to meet with individuals in Alternative Family Living (AFL) homes and group home settings across the state in many counties in NC. Our goal is to ensure the safety and well- being of those individuals by monitoring services in their residential environment twice per quarter. This also supports Care Coordinators.
During the past quarter, we wanted to highlight two of the many AFL homes which are ensuring that individuals lives are enriched with activities that make them happy and excited. Both AFL homes have taken the summer months to go camping with individuals they care for, not once but twice. They have gone to NASCAR races and aquariums across the state. When talking with the individuals, after they return, they have wonderful stories to share, pictures to keep, a few discussed what they are planning this coming fall. The IDD Monitoring Team thought that this was powerful because it shows that community based living does work and
that providers are continuing support expands the memories and abilities of the individuals in their care.
The monitoring team has seen a vast improvement in many areas of Home and Community Based Standards (HCBS). Individuals having keys to their home, access to the pantry, and meal planning are just a few ways we can support independence. We would like to thank all the agencies that support individuals in a residential setting for listening to and implementing suggestions made by the monitoring team so that you comply to the State HCBS. We are here to assist in ensuring compliance is met by the required implementation date. Do not hesitate to ask the team member that visits your group homes or residential settings for ideas or things they have seen that help implement HCBS standards.
Reminder: Partners’ Websites
Providers are reminded that Partners has three websites to meet the needs of all of our website visitors:
- Providers, and the public, can find information pertaining to providers (such as clinical guidelines, operational forms, and information concerning credentialing, utilization management, and claims) on the Provider Knowledge Base at https://legacy.providers.partnersbhm.org/. You’ll also find
Provider Communication Bulletins and Provider Alerts on this site. - Looking for training opportunities? www.partnerstraining.org is where you will find training and events coordinated by Partners Training Academy to educate and inform those in our communities, our network of providers, and internal staff.
- Our public website, www.partnersbhm.org focuses on information for members, families, and the general public. This site is where you can find information about behavioral health, available services, how to get services, our newsletter, Behavioral Health Focus, and many other helpful topics and resources.
If you are used to going to one of our sites and need to get to another, don’t worry. We have links to the other sites at the top of every web page. Have questions or comments? If so, please email questions@partnersbhm.org.
Partners’ Housing Specialists Ready to Help You Help Consumers
Did you know that our Housing Specialists work to improve the resources for our consumers in our catchment area? They are available to come out and speak to your agency about resources, such as:
- Presentations to help you assist consumers with applying for housing and creating a household budget. Maintaining a monthly budget is a necessary skill and a goal for independent living that providers should be assisting consumers reach.
- Offer provider training on how to be a good neighbor and understanding credit. Understanding federal and state Fair Housing Laws are an essential part of preparing to obtain housing.
- Assist you with navigating Reasonable Accommodations and Reasonable Modifications needs for consumers. More information concerning Fair Housing for Tenants with Disabilities can be found at: https://www.nchfa.com/sites/default/files/page_attachments/RAGuide.pdf.
Housing specialists also have information available concerning food pantries, transportation, as well as diverse types of housing in your area.
If you would like to schedule a presentation with our Housing Team, please contact Bre Griffin, Housing Educator at bgriffin@partnersbhm.org or at 704-884-2514.
Partners Training Academy Opportunities
All Partners Training Academy sessions are FREE to registered attendees. Be sure to register at www.PartnersTraining.com.
If you have any questions about Partners Training Academy events, or would like to be added to the waiting list for a training that is already full, please contact Kali Sbalbi, Public Relations Training Coordinator, by emailing Training@PartnersBHM.org or calling 704-884-2669. For more information about attending Partners Training Academy sessions, visit our Frequently Asked Questions page.
Accurate Documentation Training
Friday, February 23, 2018, 9:00 a.m. – 4:30 p.m., Gastonia, NC (Registration)
Thursday, March 8, 2018, 9:00 a.m. – 4:30 p.m., Hickory, NC (Registration)
Description: This 6-hour training is an instructional course on the essential elements of documentation for all professionals working in community based mental health and substance use services. Participants will learn core PIE note writing concepts as well as the necessary components of service notes.
Trainer: Danielle Coleman, MSW, LCSW, ACSW
Autism Spectrum Disorder: Building on Strengths to Overcome Challenges
Tuesday, February 27, 2018
9:00 a.m. – 11:30 a.m., Gastonia, NC (Registration)
2:00 p.m. – 4:30 p.m., Hickory, NC (Registration)
Description: This workshop offers parents and professionals an in-depth look at the four core deficits of Autism Spectrum Disorder (ASD): communication, social interaction, sensory issues, and how an individual may think and learn.
Trainer: Nancy Popkin, Autism Resource Specialist, Autism Society of North Carolina
Person Centered Thinking
Tuesday, March 6 – Wednesday, March 7, 2018, 9:00 a.m. – 4:30 p.m., Hickory, NC (Registration)
Description: This activity-filled, two-day training consists of applied stories, guided exercises, group work and discussion, wherein the participants acquire core skills in person centered thinking.
Trainer: Evelyn McGill, MA, LPC, LCAS, CSI, NCC
Person Centered Planning
Friday, March 9, 2018, 9:00 a.m. – 4:30 p.m., Hickory, NC (Registration)
Description: This 6-hour training addresses the values and essential elements of being a person-centered thinker, and teaches the instructional elements of completing the person-centered plan. This training fulfills the requirement set in place by the NC Division of MH/DD/SAS for Qualified Professionals.
Trainer: Danielle Coleman, MSW, LCSW, ACSW
Motivational Interviewing in Group Therapy
Wednesday, March 21, 2018, 8:30 a.m. – 4:30 p.m., Gastonia, NC (Registration)
Description: This training is appropriate for any direct service provider who provides client care in a group setting (or plans to provide client care in a group setting) and who has completed Introduction to Motivational Interviewing.
Trainer: Laurie Conaty, MSW, LCSW, LCAS
Introduction to Dialectical Behavior Therapy (Class Full)
Thursday, March 22 – Friday, March 23, 2018, 8:30 a.m. – 4:00 p.m., Gastonia, NC
Description: Dialectical behavior therapy (DBT) treatment is a cognitive-behavioral approach that emphasizes the psychosocial aspects of treatment. DBT is a support-oriented, cognitive-based, and collaborative method for teaching people how to cope with sudden, intense surges of emotion. DBT is a support-oriented, cognitive-based, and collaborative method for teaching people how to cope with sudden, intense surges of emotion.
Trainer: Laurie Conaty, MSW, LCSW, LCAS
Alternatives to Guardianship: Supported, Not Supplanted Decision-Making
Wednesday, March 28, 2018
10:00 a.m. – 12:00 p.m., Gastonia, NC (Registration)
3:00 p.m. – 5:00 p.m., Hickory, NC (Registration)
Description: If you are considering guardianship or are currently a guardian, this session is a must for you. We will explore how to provide just the right amount of support for people with disabilities as they make good and bad decisions, and grow and learn from them all.
Trainer: Holly Stiles, Senior Attorney, Disability Rights North Carolina
Alerts and LME/MCO Joint Communication Bulletins
Provider Alerts are sent to all providers subscribed through Constant Contact for “Information for Providers” and “All Partners’ Communications.” Published alerts are available on the Provider Knowledge Base at https://legacy.providers.partnersbhm.org/provider-alert-archive/.
Alerts issued since the last Provider Bulletin:
February 2, 2018 – Provider Feedback Requested—What do you know about Electronic Health Records?
All LME-MCO Joint Communication Bulletins can be found at http://www.ncdhhs.gov/divisions/mhddsas/joint-communication-bulletins.
Providers are encouraged to review the monthly NC Division of Medical Assistance Medicaid Bulletin. Bulletins are posted at https://dma.ncdhhs.gov/documents/2018-medicaid-bulletin-and-index. Some articles that may be of interest are:
- Provider Guidelines for Post-Payment Audits
- NC HealthConnex Connection Required by June 1, 2018, for Medicaid Hospitals, Physicians and Mid-Level Practitioners and Extension Process
- Medicaid Required Enrollment Fees – UPDATED
- Update to NC Medicaid Electronic Health Record Incentive Program
- Avoid Delays in the Processing Provider Enrollment Applications
- Clinical Coverage Policies
- Change in Edit Disposition: Claims Pended for Incorrect Billing Location
These articles (in addition to others) are available under the February 2018 Medicaid Bulletin on the Department of Medical Services’ 2018 Bulletin page.
Announcements and Reminders
Adolescent Males and Sexual Reproductive Health Training: Registration is now open for the Adolescent Males and Sexual Reproductive Health Training taking place on March 8 from 9 a.m. – 4 p.m. Space is limited to the first 25 that register (Registration deadline is March 1, 2018). There is no registration fee and lunch will be provided!
When: Thursday, March 8, 9 a.m.-4 p.m.
Where: Partners Behavioral Health Management Auditorium, 901 S. New Hope Rd., Gastonia, NC 28054
To register, visit https://www.surveymonkey.com/r/NSS358B
Statewide ASAM and MAT Training: The NC Department of Health and Human Services, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services announces several training opportunities for providers serving people with substance use disorders. The programs are jointly provided with Mountain AHEC and in collaboration with the NC AHEC System.
Courses include:
- The ASAM Criteria Skill Building Two-Day Training
- The ASAM Criteria Overview One-Day Workshop
- Making Medication-Assisted Treatment More Meaningful: Using Evidence- Based Practices to Promote Recovery
Trainings will be held in March and April. Training dates and locations can be found at http://my.ncahec.net/education.php.
Save the Date—NC TIDE Spring 2018 Conference: NC TIDE will host its Spring 2018 Conference April 22-25, 2018 at the Hilton Wilmington Riverside. Visit www.nctide.org to learn more.
Introduction to IPS for Behavioral Health Webinars: The Introduction to IPS for Behavioral Health webinar is now scheduled for January-March 2018.
Training objectives include:
- Recognizing how employment impacts wellness and benefits all people who have a mental illness,
- Learning about the philosophy and practice principles of the Individual Placement and Support (IPS) model,
- Reviewing the components of behavioral health integration, and
- Understanding how all roles within the behavioral health agency can support the implementation of IPS.
The webinar is a mandatory training for all behavioral health staff who are identified on the MOU/MOA or written agreement as attendees to the Employment Behavioral Health Team between the behavioral health agency and the IPS team for whom they are connected. This training is for behavioral health staff/mental health Supported Employment providers ONLY. This training will be offered once monthly with a capacity for 30 participants. A reminder that there is a six-month period in which behavioral health staff must complete the training while billing for the EBHT meeting.
Registration-March 9, 2018 at 10:00 a.m.-11:30 a.m.: https://www.eventbrite.com/e/ips-for-behavioral-health-tickets-41341655003; Password: IPS2018
Participants should register for one date only as there are limited spaces. Webinar information will be sent to registrants within 24-48 hours prior to webinar date. Certificates will be provided upon completion. Please note that continuing education credit is not currently available via DMHDDSAS online training for licensed staff.
If you have questions, please contact Nicole Ness, Adult Mental Health Program Coordinator, DMHDDSAS Community Services and Supports, at 919-715-2454 or nicole.ness@dhhs.nc.gov.