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Provider Communication Bulletin #161

In This Bulletin:

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ASL Providers Eligible for Medicaid Reimbursement

The N.C. Department of Health and Human Services (NCDHHS) is working with the Division of Services for the Deaf and Hard of Hearing (DSDHH) to improve healthcare access for Deaf, Hard of Hearing and Deafblind members. A key barrier to care is the limited number of providers fluent in American Sign Language (ASL).

To address this, DSDHH is offering reimbursement for communication access services to registered ASL-fluent healthcare providers. Additionally, registered providers will receive free training and guidance and be listed as ASL-accessible providers to help increase member access.

To qualify, providers must register with DSDHH’s Medicaid Communication Access Service. Once registered, they may be eligible for reinstatement for services provided to Medicaid and Health Choice beneficiaries and their companions.

For more details or to register, visit the Medicaid Communication Access Service webpage. For questions, contact DSDHH.Medicaid.CommAccess@dhhs.nc.gov.

State-Funded Services – Process Review and Reminder

State-funded services provide support for individuals with mental health, intellectual and developmental disability (I/DD), traumatic brain injury (TBI) and substance use disorders (SUD) outside of Medicaid. 

Waiting List and Service Approvals

State-funded providers can serve members referred to them if funds are available in their contract. Some services, like mobile crisis and Medication-Assisted Treatment, do not require screening. For a full list of services, see Partners’ Benefit Grids.

Certain services, such as residential programs, require prior approval due to funding constraints. Providers must submit the State-Funded Service Request & Waiting List Form with all required documentation. Incomplete forms cannot be processed and will delay approval.

Recipients who cannot be served immediately will be added to Partners’ State-Funded Waiting List.

Providers must also maintain their own waiting lists and submit to Partners weekly for inclusion in the statewide list. The State uses this data to assess future funding needs. Note: The State-funded waitlist submission form is not a funding request.

Reminder for SUD providers:

  • If funds are available in their contract, SUD providers do not need to go through the waiting list process.
  • Providers must still request prior authorization from Partners’ Utilization Management department, demonstrating medical necessity.
  • If no funds are available, SUD providers must follow the waiting list submission and pre-approval process.

For questions, email Partners’ Waitlist Coordinator at StateFundsWaitlist@PartnersBHM.org.

Supportive Housing Training Series

Partners Health Management’s Housing team will present a series of virtual training courses for providers, internal staff and our community partners who want to learn more about helping households find, obtain and maintain housing.

The training series will be offered from 11:30 a.m. to 12:30 p.m. on the fourth Thursday of each month from Feb. 27, 2025, through June 26, 2025.

Here are the topics and dates:

  • Feb. 27, 2025: Landlord Engagement
  • March 27, 2025: Landlord Incentives and Retention
  • April 24, 2025: Tenancy Supports
  • May 22, 2025: Reasonable Accommodations and Modifications
  • June 26, 2025: Coordinated Entry

Member Café Reminder

Please remind your members to join us for this month’s Partners Member Café, where they can voice their concerns and learn about valuable resources and services.

Partners Member Café
This Month’s Topic: Honoring Developmental Disabilities Month – Support Groups for Members and Families
Date: Tuesday, March 11, 2025
Time: 1-2 p.m.

Overview: March is National Developmental Disabilities Month. This session will share information about local intellectual and developmental disability (I/DD) support groups. Members and families can learn about groups led by people with similar experiences and find a place to connect and share.

Members can register here.

On-Demand Webinars for Providers

Partners offers valuable on-demand training webinars to help providers stay informed and meet important requirements. These short trainings are easily accessible on the bottom left side of the page under Provider Tailored Plan On-Demand Webinars at Partners Training.

Available Webinars:

EPSDT Training – Learn about the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, including:

  • EPSDT requirements and periodicity schedule
  • Diagnostic treatment components
  • Medical necessity review and service coordination
  • Key services (e.g., Vaccines for Children, NC Infant-Toddler Program referrals)
  • Important details on diagnosis codes, modifiers, referrals, tracking, follow-up and outreach

Into the Mouths of Babes (IMB) Training – The IMB program trains medical providers on preventative oral health services for Medicaid-insured children (from tooth eruption to 42 months old). Key topics include:

  • Preventing and reducing early childhood tooth decay
  • Increasing referrals of high-risk children to a dental home
  • Meeting the required training to receive IMB service reimbursement

More Training Available

In addition to these webinars, Partners Training Resource and Collaborative (TRAC) offers a variety of other on-demand and live training opportunities for providers. Explore additional topics that support compliance, best practices and service delivery at www.partnerstraining.org.

These trainings are quick, informative and essential for providers—watch today to stay up to date!

IRIS Incident Reporting Reminders

All providers of publicly funded services are required to submit Level II and Level III incident reports in the North Carolina Incident Response Improvement Center (IRIS) within 72 hours of becoming aware of the event. This applies to:

  • Category A Providers: Providers of publicly funded services licensed under NC General Statutes 122C, except hospitals.
  • Category B Providers: Providers of publicly funded non-licensed periodic or community-based mental health, developmentally disabled and/or substance abuse services.

Key Requirements:

  • Timely Reporting: Level II and Level III incidents must be reported in IRIS within 72 hours of discovering the incident.
  • Immediate Notification for Level III Incidents: Level III incidents must be reported to Partners immediately. For Partners members, notifications can be sent to IRIS@PartnersBHM.org.
  • Accurate Demographic Information:
    Ensure all demographic details are complete and accurate, including:

    • Correct spelling of the member’s name
    • Date of birth
    • Host Local Management Entity/Managed Care Organization (LME/MCO) county (county where services are provided)
    • Home county (county where the member’s Medicaid originates)
    • Member’s LME/MCO number
    • Client Record Number
    • CNDS ID
    • Medicaid ID
  • Documentation Submission: Submit all requested documentation within five business days from the date of the request.
  • Provider Contact Information: Provide the name, phone number and email address of the appropriate staff or supervisor in all IRIS reports to allow Partners to reach you if needed.
  • Daily IRIS Report Follow-Up: Check your submitted IRIS reports daily for any comments, follow-up requests or documentation needs from Partners.

Additional Resources:

Claims Information

Partners has observed a rise in claims status inquiries from clearinghouses. Providers using a clearinghouse for claim reconciliation must ensure that their staff have access to remittance advice.

Providers are reminded to contact the Claims Department at ClaimsDepartment@PartnersBHM.org for all claims related questions. To avoid delays in receiving a response, please do not contact individual claims staff directly.

Explanation of Benefits requests for Coordination of Benefits Claims

As a reminder, Partners does request copies of the Explanation of Benefits for claims submitted indicating Coordination of Benefits. The request will originate via email from Partners Claims staff. Once requested, please submit the information via secured email prior to the date indicated in the emailed request. If a response is not received, the original claim payment will be recouped.

Reminder: Taxonomy Code 193200000X and 193400000X: Taxonomy Code 193200000X and 193400000X should not be submitted on claims as the rendering taxonomy code. All claims submitted with this taxonomy code as the rendering code will be reverted.

Reminder: Please remember to include all diagnosis codes on claims. This allows Partners to measure member health, identify areas of risk and evaluate the quality of care.

Member/Recipient Eligibility and Enrollment

Providers are encouraged to contact the Eligibility and Enrollment Department at EligibilityEnrollment@PartnersBHM.org for eligibility and enrollment related questions.

To request an enrollment, providers should go to Alpha+ Home Page>Enrollments. University is an available resource for providers as a basic guide for navigating enrollments. For more information, go to University>Provider Portal Handbook>Enrollments.

If additional enrollment training is needed, email EligibilityEnrollment@PartnersBHM.org to schedule one-on-one training. Note that providers will need Microsoft Teams’ screen sharing capabilities for more provider specific and in-depth training.

Physical Health Claims

Partners Health Management has partnered with Availity®, an independent company, to operate and service our electronic data interchange (EDI) and portal transactions with Carolina Complete Health for Physical Health Claims processing.

The change took place July 1, 2024.

Availity® can now be found in ProviderCONNECT called “Physical Health Claims” under the Quick Links box.

Reminder: Mail Physical Health paper claims to:

Partners Health Management
Attn: Claims
PO Box 8002
Farmington, MO 63640-8002.

Recent Provider Alerts

Training Resource and Collaborative (TRAC)

TRAC offers a centralized cross-functional selection of required training, collaboratives and events. TRAC provides a centralized hub for cross-functional required training, collaboratives and events.

Please note: the way you register for TRAC trainings and meetings has recently changed.

Click here to view what is coming up and register.

Monthly and Quarterly Meetings

To view meeting times and register, please visit PartnersTraining.org. Email Training@PartnersBHM.org for accommodation requests.

  • Autism Services Learning Collaborative
    Engage with Utilization Management to discuss service updates and essential information.
  • CBT Learning Community (Monthly Meeting)
    Join a community of providers to explore skills, concepts, case studies, and expand techniques for using evidence-based practices. Earn 1.5 CE credits while enhancing your professional growth and improving care quality.
  • Global Continuous Quality Improvement Meeting
    Collaborate with providers, the Provider Advisory Council, and stakeholders to develop quality improvement strategies and measurable outcomes that enhance integrated health services and care quality.
  • Long Term Community Supports (LTCS) Collaborative
    Discuss the implementation of Medicaid In-Lieu of Service – Long Term Community Supports (LTCS), address barriers to service access, and ensure service continuity and quality for members.
  • Partners Provider Forum
    Stay updated with quarterly vital information and updates tailored for providers.
  • Provider DEI Collaborative
    Engage in discussions on diversity, equity, and inclusion (DEI) to promote health equity and improve outcomes. Providers’ perspectives are vital for fostering actionable strategies for integrated care.

Provider Open House
A quarterly virtual event for new and existing providers to address questions and receive support, including one-on-one training opportunities. Providers with state funding contracts are encouraged to attend.

Live Virtual Trainings

To view the currently available training courses and register, visit PartnersTraining.org. Email Training@PartnersBHM.org for accommodation requests.

  • Acceptance and Commitment Therapy (ACT)
    Explore ACT’s six core processes for developing psychological flexibility and using the ACT Matrix to help clients value-driven action. This training is NCSAPPB approved for six hours.
  • Becoming an Ally for LGBTQ Clients
    Gain knowledge and strategies to effectively support LGBTQIA2S+ individuals and promote affirming environments.
  • Connecting Community Support Team and Permanent Supportive Housing (CST-PSH) Training
    Learn the CST-PSH evidence-based model for tenancy support services. This training fulfills NC Service Definition requirements for 15 hours.
  • Dialectical Behavior Therapy (DBT) for Complex Cases
    Understand and apply DBT techniques to treat complex mental health cases. Approved for 6 NCSAPPB hours.
  • HIV & Ethics
    Stay updated on HIV diagnosis and treatment trends while exploring ethical decision-making and social determinants of health. Approved for 6 NCSAPPB hours (three HIV, three Ethics).
  • Illness Management and Recovery (IMR)
    Develop skills to support recovery and manage mental illness using evidence-based strategies. Approved for six NCSAPPB hours.
  • Mindfulness and Recovery Training
    Discover mindfulness techniques for stress management and recovery in mental health and substance use. Approved for six NCSAPPB hours.
  • Motivational Interviewing Training
    Learn the fundamentals of Motivational Interviewing (MI) to support client behavior change. This 13-hour training meets NC Service Definition requirements.
  • NCSNAP Training
    For forms, schedules, and instructions, email Training@PartnersBHM.org.
  • Person Centered Thinking (PCT) 3-Day Training
    Engage in interactive exercises and discussions to support people with disabilities. Approved for 12 contact hours.
  • Trauma Informed Care and Seeking Safety
    Learn principles of trauma-informed care and the Seeking Safety program for addressing trauma and substance use. Approved for six NCSAPPB hours.
  • Trauma Informed Interventions for People Who Support I/DD Members
    Explore trauma’s impact on individuals with IDD and learn trauma-informed strategies.
  • Treating SUD During the Modern Opioid Epidemic
    Examine the opioid epidemic’s scope and explore evidence-based treatments, including medication and CBT. Approved for six NCSAPPB hours.
  • Twelve Step Facilitation Training
    Review TSF principles, treatment models, and recovery pathways for substance use disorders. Approved for six NCSAPPB hours.

Tailored Plan Provider On-Demand Trainings

The North Carolina Department of Health and Human Services (NCDHHS) requires the listed training courses to be available for providers. This applies to Tailored Plan, Medicaid Direct and State-funded providers. Registering is easy. You will be prompted to enter simple registration information. The on-demand training will then be available immediately or when your schedule allows. Note: Training Reciprocity Among Tailored Plans. NCDHHS is allowing the six LME/MCOs reciprocity for some Tailored Plan-required training courses.

All on-demand training courses can be accessed through PartnersTraining.org.

  • CLAS Standards (35:55)
    Reviews culturally and linguistically appropriate services (CLAS) standards for health equity and cultural competence. No CE credits available.
  • Due Process (33:07)
    Covers four dispute types: Medicaid appeals, non-Medicaid appeals, Provider disputes, and Grievances. No CE credits available.
  • EPSDT (18:26)
    Explores EPSDT requirements, periodicity schedules, diagnostic/treatment components, and service coordination. No CE credits available.
  • Fraud, Waste, and Abuse (20:47)
    Overview of compliance, regulatory programs, and the impact of fraud, waste, and abuse on healthcare. No CE credits available.
  • Into the Mouths of Babes (4:10)
    Focuses on oral health services for Medicaid-insured children. Required for reimbursement eligibility. No CE credits available.
  • Hand Washing & PPE (12:40)
    Infection control training emphasizing handwashing and personal protective equipment (PPE). No CE credits available.
  • Infection Control: Community Care Settings (8:53)
    Focus on infection transmission, precautions, and member education in community care. No CE credits available.
  • Infection Control: Home Care Settings (9:55)
    Highlights infection control procedures in home care settings. No CE credits available.
  • Prevention & Population Health Management (18:52)
    Discusses Partners’ health improvement approach, program goals and provider expectations. No CE credits available.

Provider On-Demand Trainings

  • 1915(i) State Plan Amendment Training (1:09:45)
    Overview of 1915(i) services. Includes Q&A.
  • Client-Specific Training Webinar (June 2024)
    Topic-specific training for providers.
  • Crisis Response Training (3 hours)
    Comprehensive guide to crisis intervention strategies. Contact hours available.
  • Critical Incident Reporting (CIRT/IRIS) (15:20)
    Training on incident reporting procedures.
  • Community Support Team (CST) Service Definition (3 hours)
    Behavioral health support for severe mental illness. Meets CST Service Definition requirements. Three contact hours available.
  • Employer of Record Webinar (27:37)
    Covers EOR monitoring, documentation, and quality management. No CE credits available.
  • Enhanced Rate Request Webinar (25:58)
    Step-by-step ERR form completion and cost finding instructions. No CE credits available.
  • Health Disparities: A Tribal Perspective (29:12)
    Explores health disparities among tribal populations and Medicaid’s role. No CE credits available.
  • Plan of Correction Webinar 2024 (10:16)
    Training on crafting effective plans of correction.
  • Tobacco-Free Recovery (4:45)
    Encourages tobacco-free practices for better health outcomes.

ProviderCONNECT Trainings

  • User Navigation Guide Video
    Introduction to ProviderCONNECT portal features.
  • LA Non-Utilizer Report Video
    Guides administrators on maintaining user accounts.
  • Secure Messages Video
    Instructions on secure communication via ProviderCONNECT.
  • Document Manager Video
    Guide to using the Document Manager for file sharing and management.
  • SysAid2 Service Ticket Overview Video (8 minutes)
    Overview of the service ticket system.

Physical Health Provider Trainings

  • June 2024 Tailored Plan EVV Info Session (11:32)
    Covers Electronic Visit Verification requirements. Includes FAQ.
  • May 2024 Physical Health Providers Update (40:36)
    Updates on tailored plans and care management. Includes FAQ.
  • March 2024 Physical Health Providers Update (56:31)
    Collaboration strategies between providers and Partners Health Management.

Community Training

Stress Management
March 4, 2025 | 10 a.m. – noon (Register)
We’re all stressed! Many of us are balancing jobs, school, family, finances and more. Let’s get together and talk about ways we can manage our stress and have a little fun. 

Diabetes 101
March 6, 2025 | 10 a.m. – noon (Register)
The Diabetes 101 training provides a comprehensive overview of diabetes, including its types, signs, symptoms, risk factors, and potential complications. Participants will gain knowledge about diabetes prevention, self-management strategies, and valuable resources to support those affected by the condition.

Community Resiliency Model (CRM)®
March 6, 2025 | 2 p.m. – 4 p.m. (Register)                                          
The Community Resilience Model (CRM)® teaches participants about the impact of trauma and chronic stress on the nervous system, behavior, and long-term health. Participants learn how to reset the nervous system with easy to learn, concrete coping skills. One of the goals of CRM is to create trauma informed and resilient communities.

Risk and Resilience: Buffering Toxic Stress 
March 7, 2025 | 10 a.m. –  noon (Register)
Learn about early childhood stress and trauma and how it can result in negative outcomes in areas of learning, behavior and health throughout the lifespan. We discuss interventions to buffer the impact of toxic stress. Learn how to help younger children calm their limbic systems. We will discuss helping older children heal the cortical brain and develop active coping skills including impulse control and problem solving.

Domestic Violence: How to Help      
March 11, 2025 | 10 a.m. – noon (Register)
Many of us are at home more than usual and the risk of domestic violence is high. Learn how to spot the warning signs of domestic violence and how to help someone in a violent situation.

Partners Member Café
March 11, 2025 | 1-2 p.m. (Register)
Partners Member Café is held the second Tuesday of each month. Grab a cup of coffee, sit down and join us virtually to get to know us and learn how we can help you. Ask us questions about the resources and services you need and who to call. We look forward to seeing you!

Active Listening/De-Escalation   
March 13, 2025 | 10 a.m. – noon (Register)
This training focuses on active listening skills, empathy, and habits to keep yourself and other people safe. There will be a discussion about how our own experiences impact our ability to assist others in high-stress situations.

Human Trafficking: Keeping Our Children Safe   
March 14, 2025 |10 a.m. – noon (Register)
Human Trafficking is a global problem, even in the United States. Children may be susceptible to online predators. Learn about trafficking around the world and some ideas about how to keep our children safe. This training addresses sexting briefly.

Substance Use Disorder: Overview, Recovery, and Resources
March 18, 2025 | 2 – 4 p.m. (Register)
This training provides an overview of substance use disorder, including its effects on mental and physical health, while identifying specific substances and their impacts. Participants will gain valuable insights into recognizing substance-related challenges and accessing helpful resources. Join us to explore practical strategies for supporting individuals impacted by substance use disorder.

Question, Persuade, Refer (QPR) Suicide Prevention  
March 19, 2025 | 10 a.m. – noon (Register)
This evidence-based training teaches the skills to recognize warning clues of suicide and intervene in a suicide crisis. “Ask a question, safe a life.” *The maximum number of people allowed to participate in a virtual QPR training at one time is 30; registration is on a first-come, first-served basis.

Maternal Mental Health      
March 19, 2025 | 2 – 4 p.m. (Register)
This training delves into the nuances of maternal mental health, perinatal mood disorders and practical tools for support. Explore the essential intersection of mental health, pregnancy/postpartum care and social determinants of health while gaining insights that contribute to creating a nurturing environment for mothers.

 

Mental Health 101
March 20, 2025 | 10 a.m. – noon (Register)
Learn about mental wellness, potential signs and symptoms of mental health challenges and some of the common behavioral health disorders. This training also includes information about treatment and what to do in a crisis.

Trauma Part 1: Introduction To Trauma and Resilience  
March 21, 2025 | 10 a.m. – noon (Register)
Most of us have experienced trauma at some time. This can have a lasting effect on our learning, behavior and health. Learn about trauma, how to address the effects and develop resilience.

Nutritional Impact on Mental Health
March 25, 2025 | 10 a.m. – noon (Register)
Join us for an insightful training on the intricate relationship between eating behaviors and mental health. This interactive training will explore how our dietary choices and habits can profoundly influence our mental well-being, emphasizing the crucial connection between nutrition and mental health.

Partners Community Café     
March 26, 2025 | 10 – 11 a.m. (Register)
March is Disability Awareness Month. Café presenters will discuss opportunities for training, education, and employment for individuals who are differently abled.

Understanding Grief
March 27, 2025 | 10 a.m. – noon (Register)
Are you experiencing grief, or do you know someone who is grieving? In this training, you will learn about the various causes, phases and other information related to the grieving process.

Trauma Part 2: Trauma Informed Care
March 28, 2025 | 10 a.m. – noon (Register)
We will look at how our behavior affects others who have a history of trauma. Learn about the elements of trauma informed care.  A childcare specific version is available on request.

Non-Suicidal Self-Injury
March 31, 2025 | 2 – 4 p.m. (Register)
Learn about Non-Suicidal Self-Injury, what causes people to injure themselves, warning indicators and what we can do when we encounter someone who self-injures

In-Person Trainings

Virtual System of Care Training: An Introduction to Child and Family Teams (CFT): A Cross System Training from the Family’s Perspective (Part 1)
Apr. 15-16, 2025 | 9 a.m.- 4 p.m. (Register)

This System of Care training will be virtual. CFT Part 1 is a two-day experiential training course (when you register, you agree to attend both days) with the goal of providing an overview of Child and Family Team meetings from the family’s perspective. The training seeks to reinforce the idea of “one family, one plan” by addressing CFT through the lens of multiple systems as they affect families in their everyday lives. Agency representatives and parents/family members 18 years old and older are encouraged to attend this training. Sessions must have a minimum of 10 participants. Do not schedule other appointments during this training. For more information, email CETraining@PartnersBHM.org.

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