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Crossroads, Mental Health Partners, and Pathways are merging on July 1, 2012 to form Partners Behavioral Health Management. The following is important Provider information relative to the merger and operational processes beginning July 1, 2012.
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Posted February 25, 2013. Direction regarding Associate Licensed Professional/H Codes; Provider Information Request --Relative/Legal Guardian as Direct Support Employee; LOCUS/CALOCUS/ASAM Reminders; Psychological Testing Guidelines; Person Centered Plans for Medicaid and IPRS; Use of 90785: Interactive Complexity; “New” and “Established” E/M Coding; Partners-Sponsored and DHHS-Sponsored Provider Trainings--LOCUS/CALOCUS, ASAM, Program Integrity for Providers; Partners Wants You to Know--Website Updates, New Enrollee Information, Customer Services/Access to Care Questions, Enrollee Education Sessions, March Provider Forums
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Revised March 4 , 2013 (phone number correction.) IN THIS BULLETIN: Value Options Authorizations, Attention Outpatient Providers requesting Basic Benefit Services, Clarification on Unmanaged Visits and Psychological Testing, Important Information about 837 Files, Use of Local Modifiers for Authorizations; Partners BHM Wants You to Know:
NC DHHS DOJ ACT Implementation—Introduction to the Tool for Measurement of ACT; March Provider Forums; March Enrollee Education Sessions; Website Updates
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Published March 15, 2013. Please open to view topics.
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Posted March 25, 2013. IN THIS BULLETIN: REVISED Residential Support Rates to Change Effective April 1, 2013; Clarification on Back-Up Staffing Incident Reporting Procedure; Utilization Management Information: Attention ICF-IID Providers, Authorization Info for Day Treatment Providers, REVISED Medicaid and IPRS Benefit Grids, Reminders, Issues Partners BHM is aware of; REVISED Quarterly Level I Incident Report Reminder with Additional Info; Web Updates; Partners BHM Sponsored Meetings and Training--Community Guide Meeting (I/DD), Day Treatment UM Technical Assistance Training, NC TOPPS Training, Critical Case Conference, ASAM Training, NC Implementation of USDOJ Settlement Agreement Supportive Employment Consultation Meeting
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In this Bulletin: From Provider Network Management--Attention Providers—Do you have your current licensure information on file?; Partners Provider Council Meeting: Finance and Claims Information--Standardized Check Write Schedule, Diagnostic Coding Tips for Billing, Claims Denial Review Process, Remittance Advice, Reminder about Principal Diagnosis, TIPS for submitting Level II-IV Residential Claims, THERAPEUTIC LEAVE (0183) for MEDICAID BILLABLE SERVICES, Advanced Payments, Tips for working denials; Utilization Management Information--CORRECTION-Functional Behavioral Assessments and Behavioral Intervention Plans, CPT codes 90791 and 90792 (Psychiatric Evaluation); Intellectual/Developmental Disabilities and NC Innovations--Relative/Legal Guardian as Provider Process, List of Community Guide and Agency with Choice Providers, NC Innovations Category on Partners BHM Website; Partners Wants You to Know--We Want Your Feedback (survey), Building capacity for NC Certified Peer Support Specialists, ASAM Training , NC Implementation of USDOJ Settlement Agreement Supportive Employment Consultation Meeting;
State News--Medicaid Special Bulletin, NCTracks Newsletter Available
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(Published May 1, 2013) IN THIS BULLETIN: From Provider Network Management--Provider Monitoring, May Partners Provider Forum, Do you have your current licensure information on file? Finance and Claims Information--Standardized Check Write Schedule; Utilization Management Information--Attention Day Treatment Providers, CPT Code 90785, Benefit Grids; Partners Wants You to Know--Memo to Hospitals and Mobile Crisis Providers regarding Mobile Crisis Teams and the Redesign of the Mobile Crisis Services, Consumer Explanation of Benefit Questionnaires, Reminder to ACT Teams from the Division of MH/DD/SAS; State News--Communication Bulletin #131, Western Highlands Network and Smoky Mountain Center Announce Plans
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IN THIS ISSUE:
Partners BHM Contact Information
Alpha MCS Information and Training
Authorization for Use, Disclosure, and Exchange of Protected Health Information
Medicaid Pass-Through Billing
Provider Dispute Form
Reminder-Electronic Funds Transfer Participation
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IN THIS ISSUE: Network Enrollment Applications; Trying to contact Partners BHM?; Authorization Requests Calls to Access to Care by persons with Private Insurance; Calls to Access to Care by persons with Medicare; Mobile Crisis Scheduling; State Funded (IPRS) Sliding Fee Scale; NCTOPPS; New Compliance Program; Level I Incident Reports;
Alpha MCS Updates
Partners BHM Provider Manual Update
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IN THIS ISSUE: A Word from Rhett Melton, Partners CEO; Partners Check Write Schedule; Partners Trading Partner Agreement; Partners 837 Companion Document; Alpha MCS Provider Files; SARS and the Benefit Plan;
Alpha MCS Scheduler Enhancements; Claims Processing; Additional Alpha MCS Provider Trainings Available; Provider Credentialing and Enrollment; Authorization for Use, Disclosure, and Exchange of Protected Health Information.
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IN THIS ISSUE: DON’T FORGET TO SUBMIT YOUR APPLICATION!
Information regarding consumers with Medicare/Private Insurance; NC TOPPS Submissions; Provider Specialist Assignment List; Alpha MCS Questions and Answers; Partners Provider Council; Upcoming Provider Trainings and Events
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IN THIS ISSUE: Information for Providers who have not applied for the Partners BHM Network, Consumer Enrollment Process, Provider Orientation Toolkit, Service Authorization Request for Enhanced Services, AlphaMCS Information,
Care Reviews, Mental Health/Substance Abuse Targeted Case Mgmt. Transition Team Meeting, Provider Forums,
Intellectual/Developmental Disabilities Community Education Forums, Partners Provider Council, Child Collaborative Meeting Time Changes
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IN THIS BULLETIN: Billing by Associate Licensed Professionals, Check your AlphaMCS Provider Profile!; Medicaid Authorization Requests (REVISED on Jan. 24), Letter to Medicaid Recipients Regarding 1915 (b)/(c) Waiver, Provider Quarterly Incident Reports, Partners BHM Checkwrite Schedule, Special Medicaid Bulletins, CPT Conversion and AlphaMCS,
Training Dates, January Provider Forums, Previous Items Referenced in Coffee Break.
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IN THIS BULLETIN: General Information (February Provider Forums, AlphaMCS Online Training, AlphaMCS Alerts, Letter to Medicaid Recipients Regarding 1915 (b)/(c) Waiver, Partners BHM’s Rates for NC Innovations—Services and Supplies, Provider Agencies selected for “Community Guide” and “Agency with Choice” Services); Contracting with Partners BHM; Information about Authorizations/Utilization Management (Documentation requirements for a SAR to be processed, Medicaid Authorization Requests, Transfer of authorizations from Value Options to Partners BHM, Initial Authorizations versus Concurrent Authorizations, Medicaid Psychiatric Inpatient Authorization Process, Authorizations for Enrollees transitioning from CAP-MR/DD Waiver to NC Innovations Waiver); Care Coordination Transition; State Information (Implementation Update #100; Special Medicaid Bulletins)
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Partners UM Fax Number Modified on Feb. 12, 2013.
IN THIS BULLETIN: Enrollee Education Sessions; AlphaMCS Information (Log In Requests, Training); Information about Authorizations/Utilization Management (Outpatient Behavioral Health Therapy--Unmanaged Visits; ICF-IID Authorizations, Authorizations for Residential Level III and IV); Claims and Billing (Claims Processing, Billing by Associate-Licensed Professionals, “Incident To” Billing and Outpatient Behavioral Health Services by Psychiatric Nurse Practitioners and Physician Assistants, 837 Submissions)
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Posted and REVISED April 5, 2013. IN THIS BULLETIN--April Provider Forum Change, Attention IPRS (State-Funded) Providers—Agreement Renewal, Additional Check Write, AlphaMCS Claims Guide; Utilization Management Information--Expedited Reviews, Documentation Reminder for Residential Level III, IV or PRTF, Day Treatment Service Definition, Benefit Grids; Partners BHM Sponsored Meetings and Training--An Introduction to Child and Family Teams: A Cross System Training from the Family’s Perspective, NC TOPPS Training, Critical Case Conference, ASAM, NC Implementation of USDOJ Settlement Agreement Supportive Employment Consultation Meeting. State News--Communication Bulletin #129, Special training for the Medicaid NC Tracks System