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Provider Bulletin #83

No Provider Council in July; Meetings Resume in August

Partners Provider Council will not meet in July. The next meeting will be held Friday, August 24, 2018 at Partners Hickory Office, Basement Multipurpose Room. Providers meet from 9:30-10:30 a.m., and Partners employees join the meeting from 10:30 a.m.-12 p.m.

In addition, the IDD Sub-Committee will not meet in July. They will resume meetings in September, directly after the Provider Council meeting. The sub-committee is also scheduled to meet in December, March, and June.

The Partners Provider Council is a professional representative and advocate for all service providers in the Partners’ catchment area. The Council facilitates an open exchange of ideas and brings forward concerns and solutions while promoting collaboration and mutual accountability among providers. All providers are welcome to attend Provider Council meetings. To learn more, please visit https://legacy.providers.partnersbhm.org/provider-council/.

Registration Open – Partners September Provider Webinar

Registration is now open for Partners September Provider Webinar, scheduled for Wednesday, September 12, 2018 at 1 p.m. To register, visit https://attendee.gotowebinar.com/register/173064621454657539.

After registering, you will receive a confirmation email containing information about joining the webinar.

Handouts and recordings of previous webinars are available at https://legacy.providers.partnersbhm.org/provider-webinars-forums/. If you have questions about future Provider Webinars, please contact Roanna Newton at 828-323-8054 or email rnewton@partnersbhm.org.

Benefit Plans

Partners has reformatted its Benefit Plans. Instead of two plans with a variety of diagnosis and age groups, eight plans have been created to make it easier for clinicians to use. The new plans can be found at https://legacy.providers.partnersbhm.org/benefit-grids/.

New Contact for Incident Reporting; Reminder for PRTF Service Providers

An incident is defined as any happening that is not consistent with the routine operation of a facility or service or the routine care of a consumer that is likely to lead to adverse effects to the individual. Incidents are classified into three categories (Level I, Level II, and Level III) according to the severity of the incident. Providers are required (as outlined in their contract with Partners) to develop and maintain a system to collect documentation on any incident that occurs in relation to a consumer. This includes all state reporting regulations in relation to the documentation and reporting of critical incidents.

  • Level II and Level III Incident Reporting: Providers must enter all Level II and Level III Incident Reports into the Incident Response and Reporting System (IRIS). In addition, providers must verbally notify Partners’ Quality Management staff at 704-772-4294 of all deaths and Level III Incidents within the appropriate timeframes.
  • Level I Incident Reporting: Partners Behavioral Health Management no longer requires submission of the Quarterly Provider Incident Report (effective July 1, 2016).  All providers should continue to track their Level I incidents internally and have those available for review when requested.  Partners will request DHHS waive this requirement for all of our network providers.  If your agency would like to not be included on this list, please contact your Provider Network Account Specialist.  If you have further questions or concerns, please email iris@partnersbhm.org.

Additional information and instruction for the process of Incident Reporting may be found at the NC Department of Health and Human Services’ IRIS website at https://iris.dhhs.state.nc.us/

REMINDER for Psychiatric Residential Treatment Facility Service Providers: LME-MCO Communication Bulletin J287, dated May 11, 2018, provides clarification regarding the use of Restraint & Seclusion for Psychiatric Residential Treatment Facilities (PRTFs) and serves as a reminder for the reporting of Serious Occurrences.

Claims Information

Providers are reminded to use the email claimsdepartment@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. 

Timely Filing Override Requests:  Please make sure claims are being submitted according to the timely filing guidelines available at https://legacy.providers.partnersbhm.org/claims-information/.  If claims deny for any of the reasons below, make sure you submit timely filing override requests within the time frames.  Timely Filing Requests should be sent directly to claimsdepartment@partnersbhm.org prior to submitting the claims.

AlphaMCS Portal University is an available resource and guide for navigating AlphaMCS.  If you need additional claims training, email rcolvard@partnersbhm.org to schedule a time for training.

Medicaid—June 2018:   Number of Days to Process and Pay All Claims
Received Date to Paid Date:    8.7 days
Top Five Medicaid Claim Denials—June 2018

Claim Denial

Provider Recommended Action Steps
Duplicate Claim The claim has previously been submitted and adjudicated. Do not refile.
No coverage available for Patient/Service/Provider combo

 

 Go to Patient -> Patient Search and search for the patient in question. Check the insurance to ensure the patient has effective insurance covering to date of service submitted on the claim. If this appears to be correct, contact the MCO for further assistance.
Service is not authorized Verify Service Authorization for the consumer. Contact Utilization Management.
Claim received after the billing period Write off charges as non-billable. Do not rebill.
Billing Taxonomy submitted is not associated with the Billing NPI Rebill claim with a valid taxonomy/NPI information.

Fair Housing Laws and Training

Fair Housing Laws have helped millions of people since its inception to provide equal access to housing and prevent housing discrimination. This act provides for reasonable accommodations and reasonable modifications, which are a valuable resource for our consumers. Reasonable Accommodations are requests to make changes to any rule, policy, or practice to afford a person with a disability the equal opportunity to use and enjoy their home. Reasonable Modifications are physical alterations to a dwelling to allow a person with a disability greater accessibility.

In order to better advocate for our consumers, having a better understanding of these laws are helpful. Partners will be hosting a Fair Housing Training on August 2, 2018at the Partners Hickory Office (Basement level). There will be a morning session, which will provide a basic overview of Fair Housing and an afternoon session for a more advanced understanding. Seating is limited, and registration is required. Please contact Bre Griffin for registration information at bgriffin@partnersbhm.org or 704-884-2514. The North Carolina Housing Finance Agency distributes a booklet with great Fair Housing information as well at https://www.nchfa.com/sites/default/files/page_attachments/RAGuide.pdf.

Registration of Interest (ROI)—Dual Diagnosis Services (IDD/MHSU, includes ASD) Residential (ROI #0718-004)

Partners issued a Registration of Interest (ROI) to determine interest from appropriately qualified organizations in providing residential services to individuals with dual diagnoses of intellectual and developmental disabilities (IDD) and mental health and substance use disorders (MHSU), including Autism Spectrum Disorder (ASD).  The location for services is within Partners catchment area.  Once interest in the provision of this service is assessed, Partners may issue a full Request for Proposals (RFP). Only qualified providers responding to this ROI will be eligible for the RFP.

Please visit https://legacy.providers.partnersbhm.org/request-for-services/ to view details regarding the ROI and access forms required for submission of interest.

Organizations interested should respond to this ROI by completing the Registration of Interest Response Form (located on the Description and Forms Tab at https://legacy.providers.partnersbhm.org/request-for-services/) by Friday, July 27, 2018 by 5 p.m.

Questions regarding this ROI should be directed to Vanessa Anderson at vanderson@partnersbhm.org.

Connect with Other LIPs at Partners’ Licensed Independent Practitioner Collaborative

The Licensed Independent Practitioner (LIP) collaborative has been developed in response to needs identified in the Partners 2016 Needs Assessment and Service Gaps analysis. Its goals are to:

  • Improve communication between Partners and Licensed Independent Practitioners
  • Increase the use of the slot scheduler by Licensed Independent Practitioners to increase service capacity
  • Identify training needs
  • Identify potential barriers to service and solutions to those barriers

The LIP Collaborative will meet via webinar on Thursday, August 9, from 12 – 1 p.m. To register, click here. For more information, please contact Roanna Newton at rnewton@partnersbhm.org or call 828-323-8054.

Partners Training Academy Opportunities

All Partners Training Academy sessions are FREE to registered attendees. Be sure to register at www.PartnersTraining.org.

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 email Training@PartnersBHM.org.

AlphaMCS Training (Registration)

Tuesday, July 24, 2018, 9:00 a.m. – 12:00 p.m., Hickory, NC

Description: Join Partners’ Claims, Access to Care, Utilization Management, and Provider Network staff for an interactive AlphaMCS module training. This open-house style training session will allow each attendee time to work one-on-one with Partners’ staff to discuss unfamiliar or problematic AlphaMCS modules. Participants are encouraged to bring their own laptops to access and review their individual workflow during the training.

Introduction to Motivational Interviewing

Thursday, August 2 – Friday, August 3, 2018, 8:30 a.m. – 4:30 p.m., Hickory, NC (Class Full)
Thursday, October 18 – Friday, October 19, 2018, 8:30 a.m. – 4:30 p.m., Gastonia, NC (Registration)

Description: Motivational Interviewing (MI) is an evidence-based treatment that addresses ambivalence to change. MI is a conversational approach designed to help people with the following:

  • Discover their own interest in considering and/or making a change in their life (e.g., diet, exercise, managing symptoms of physical or mental illness, reducing and eliminating the use of alcohol, tobacco, and other drugs)
  • Express in their own words their desire for change (i.e., “change-talk”)
  • Examine their ambivalence about the change
  • Plan for and begin the process of change
  • Elicit and strengthen change-talk
  • Enhance their confidence in taking action and noticing that even small, incremental changes are important
  • Strengthen their commitment to change

Attendance Fee: $0.00 – Attendees of this training will receive 13 contact hours for completing this session.

Trainer: Laurie Conaty, MSW, LCSW, LCAS

Documentation/Person Centered Planning

Thursday, August 16 – Friday, August 17, 2018, 9:00 a.m. – 4:30 p.m., Gastonia, NC (Class Full)
Thursday, October 4 – Friday, October 5, 2018, 9:00 a.m. – 4:30 p.m., Hickory, NC (Registration)

Description: This training is an instructional course on the essential elements of documentation. Participants will develop awareness and skills to enhance documentation competence of behavioral healthcare providers. Participants will learn the components of writing accurate service notes using the PIE format. Additionally, participants will learn the values and core concepts of being person-centered thinkers. This training will teach the instructional elements of completing the person-centered plan.

Attendance Fee: $0.00 – Attendees of this training will receive 12 contact hours for completing this session.

Trainer: Danielle Coleman, MSW, LCSW, ACSW

Introduction to Dialectical Behavior Therapy (Class Full)

Thursday, August 23 – Friday, August 24, 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. The theory behind the approach is that some people are prone to react in a more intense and out-of-the-ordinary manner toward certain emotional situations, primarily those found in romantic, family and friend relationships. DBT is a support-oriented, cognitive-based, and collaborative method for teaching people how to cope with sudden, intense surges of emotion.

Attendance Fee: $0.00 – Attendees of this training will receive 12 contact hours for completing this session.

Trainer: Laurie Conaty, MSW, LCSW, LCAS

Cognitive Behavioral Therapy (Registration)

Wednesday, September 26 – Friday, September 28, 2018, 9:00 a.m. – 4:30 p.m., Gastonia, NC

Description: Cognitive Behavioral Therapy, also known as CBT, is a type of therapy that helps a person focus on his or her current problems and how to solve them. This three-day training program teaches the essentials of CBT and prepares treatment providers to begin or continue the appropriate use of this evidence-based practice.

Attendance Fee: $0.00 – Attendees of this training will receive 18 contact hours for completing this session.

Trainer: Danielle Coleman, MSW, LCSW, ACSW

Alerts and LME/MCO Joint Communication Bulletins

Provider Alerts are sent to all providers subscribed to receive Partners’ Provider 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:

All LME-MCO Joint Communication Bulletins are located at http://www.ncdhhs.gov/divisions/mhddsas/joint-communication-bulletins.

Joint Communication Bulletins issued since the last Provider Bulletin:

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.

Announcements and Reminders

Catawba Recovery Rally: The Catawba County Adult Collaborative and Hickory Soup Kitchen are sponsoring a Recovery Rally on Saturday, September 29, 2018 at Hickory Soup Kitchen, 110 2nd St. Pl. SE, Hickory, NC 28602.

Recovery means different things to different people. Too often society thinks there is no hope for people struggling with substance use or mental disorders.  Come and see recovery is possible for anyone and there is hope and healing for people living with substance use and mental disorders. This is a free event, which includes speakers, fellowship, information, entertainment, food, and empowerment.

Providers are welcome to sign up to have a table and participate in the event. Providers participating are asked to donate an item to be raffled off.  To register for a table, please click here. If you have further questions or would like to donate a raffle item, please contact Michael Smith at msmith@partnersbhm.org or call 828-325-4693.

Darkness to Light:  Partners System of Care Department is hosting Darkness to Light training on Monday, July 23 from 6:30-8:30 p.m. at Catawba River Baptist Association, 1812 US 70 E., Morganton NC, 28655. The Darkness to Light training is free and is provided to prevent childhood sexual abuse by increasing awareness and education in communities. The training is two hours and participants are provided a certificate upon completion. This training is approved for two contact hours for social workers and nurses. There is no cost for the training. To register, click here.

Child Enhanced Services Collaborative: The next meeting of the Child Enhanced Services Collaborative will be at Children’s Hope Alliance, Little Joe’s Chapel, 107 Grannis Lane, Statesville, NC, 10 a.m.-12 p.m., July 26.  To learn more or to RSVP, please contact Jeanne Patterson at jpatterson@partnersbhm.org by July 24.  We will have a presentation on Multi-Systemic Therapy and continue discussions on collaboration and System of Care.

Youth Mental Health First Aid:  This training is recommended for teachers, coaches, social workers, faith leaders, and other individuals who regularly have contact with young people ages 12-18.  This training will be held Friday, August 3 from 8:15 a.m.-5 p.m. at Partners Hickory Office, Lobby Conference Room, 1985 Tate Blvd. SE, Hickory NC, 28602. To register, click here.

Benchmarks’ Partnering for Excellence Conference:  Benchmarks’ Partnering for Excellence (PFE) redesigns the local child welfare/behavioral health system, changing the way DSS, LME/MCOs, local providers and the wider community understand the need for accessible, appropriate mental health services for children, youth and families who have experienced potentially traumatic events. PFE bridges the cultural and financial divides between the DSS and LME/MCO by aligning processes around a common clinical assessment and shared responsibility around treatment decisions and outcomes management. View the agenda.

This event will be held August 29-30 at the Statesville Civic Center, 300 S. Center St., Statesville, NC. Cost is $140 per person. To register, click here.

Sure Bet One and Two for Providers: The Behavioral Health Springboard, Division of Mental Health, Developmental Disabilities, and Substance Abuse services are offering the following training for providers. To learn more about the programs, along with dates, locations, and registration information, please visit https://bhs.unc.edu/sure-bet/dashboard.

  • Sure Bet One is a two-day workshop covering topics of problem and pathological gambling, gambling counseling theory and practice, regulations and ethical issues, and financial aspects of remuneration.
  • Sure Bet Two is a two-day workshop providing in-depth knowledge and practice skills using Motivational Interviewing and financial counseling in problem gambling services to special populations (g. military, adolescents, young adults, older adults and females) and their non-gambling family members.

While this training is open to anyone, completion of both of these events will meet the requirements necessary for application for the NC Problem Gambling Program (NCPGP) Provider Registry. Participation in this training does not assure that a provider will be selected for the NCPGP Registry, but it is a required component of becoming an NCPGP provider. Participants must attend 100% of the program to receive credit. Partial credit will not be given. If you have questions, please email bhrp-support@listserv.unc.edu or call 919-843-6083.

NC Tracks Enrollment Verification:  As communicated in a Provider Alert dated August 24, 2017 and Provider Communication Bulletin #70, Partners is required to ensure that all provider information loaded in AlphaMCS matches the information loaded in NC Tracks for the purpose of claims processing.  This includes individual clinicians as well as provider agencies and hospitals.  If the information in NC Tracks has lapsed, expired, been terminated; or if the site/address information for an agency, a hospital, or for an individual clinician is not included in NC Tracks, then we are unable to load it in AlphaMCS.

Please note that the site/address where a clinician will be providing services must be listed in the “Name/Address” section of NC Tracks and not simply in the “Affiliation” section.  If a clinician works at multiple sites for the same provider or at multiple locations with multiple providers, all of those site addresses must be loaded in the “Name/Address” section of NC Tracks.

In situations where the information in NC Tracks does not match the request Partners receives from you, then you will receive an Enrollment Status letter from Partners’ Enrollment staff. We understand that, many times, providers may have already submitted a Managed Change Request (MCR) through NC Tracks to update the information with them.  Unfortunately, we are unable to update the information based on the MCR until we can verify the change inside NC Tracks.  Once your MCR has been processed with NC Tracks, you should receive a notification from them.  Partners does NOT receive that notification from NC Tracks, so providers should contact the enrollment group at enrollment@partnersbhm.org as soon as you are notified that the update has been completed with NC Tracks.  At that point, Partners will verify the information and update AlphaMCS.

Please note that some license types expire/renew on June 30th each year as a matter of routine.  Those license types include LPC and LCSW.  We will not be able to update the license for those clinicians inside of AlphaMCS until those licenses are updated inside of NC Tracks.  Please notify us at enrollment@partnersbhm.org as soon as the license update is complete and can be verified inside of NC Tracks.

If you have further questions regarding the content in this alert, please contact Natalie McBride at ncmcbride@partnersbhm.org or call 828-323-8048.

New Health Information Exchange (HIE) Update page:  There is now a new home for information and updates related to the Health Information Exchange (HIE) via connection to NC HealthConnex (North Carolina’s designated statewide health information exchange network) on the NCTracks website. Check out the new HIE Update page here.

Medicaid Transformation:  All providers are urged to stay abreast of the information shared by DHHS regarding Medicaid transformation and the impact it can have on their operations. Information regarding this effort can be found at https://www.ncdhhs.gov/medicaid-transformation. In addition, Partners will also highlight white papers, comment periods, and additional information in future Provider Communication Bulletins.

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