Eastpointe March 15, :00am until 1:00pm Webinar
|
|
- Alice Montgomery
- 6 years ago
- Views:
Transcription
1 Eastpointe March 15, :00am until 1:00pm Webinar
2 Welcome and Overview Karen Salacki Eastpointe Provider Network Council Nicole Bauer External Operations Updates Karen Salacki Program Integrity Melinda Weissinger First Commitment Waiver Tanisha Draughn
3 Disaster Form Reminders Relative as Provider Reminders Network Operations Updates Listserve changes Next Provider Meeting Contact Information Tanisha Draughn Becky Womble Linda Hawley Isbell Karen Salacki
4
5 Nicole Bauer
6 For Council Information: Go to then For Provider Community, the Eastpointe Provider Network Council Information Contact Information:
7 The Eastpointe Provider Network Council meets the 4 th Wednesday of the month (except November and December) They meet at Skill Creations, 2105 Royal Avenue, Goldsboro, NC Upstairs Conference Room The Provider Council is planning to outreach to all providers in our network early next year to introduce themselves and provide some information.
8 Karen Salacki Chief of External Operations
9 Our Provider Network is closed. This is for Medicaid and State Services. We are not adding new State contracts or adding services to State contracts. We are accepting applications for: Medicaid services for Psychiatrists in private practices. We are accepting applications from Hospitals. Agencies may also add an Outpatient Therapist. Agencies may add a Site to provide Outpatient Services.
10 If you are requesting to add an Outpatient Site you must follow the Add a Site process. This includes an onsite review. Please pay close attention to the changes to that process that will be discussed later in the meeting. Please remember that you cannot open a new Outpatient site or provide services at that site until you receive an approval letter from Network Operations.
11
12 If you need to add a Taxonomy Code to an approved site, please submit this request on your letterhead to networkoperations@eastpointe.net The following elements need to be included on agency letterhead: Name of Agency Date of Request Site Name that you are asking to add the taxonomy to Taxonomy Code(s) that you want to add The letter needs to be signed and dated by the CEO or designee Please add in the letter that this is a Request to add Taxonomy Codes to an approved site.
13 To avoid potential recoupment of funds, all providers need to validate the following items: 1. Check to make sure every Alpha site for which your agency bills, is in NC TRACKS with the correct billing NPI. 2. Check to make sure that you are registered for the correct Taxonomy Code for each procedure code at each site in NC TRACKS. 3. Check addresses including the zip + 4 to ensure they are matching in Alpha and NC TRACKS. 4. Make sure that the NPI and Taxonomy codes that are submitted on a claim match what is in NC TRACKS and Alpha MCS.
14
15 The Eastpointe Area Board has unanimously approved a consolidation agreement with Cardinal Innovations Healthcare. Both organizations are committed to improving the health and well-being of special populations in North Carolina. The transition is expected to be complete by July 1, The next step is for regulatory approval by the Secretary of DHHS.
16 We encourage you to keep up to date on consolidation efforts by: Attending monthly Provider Meetings Reviewing Eastpointe Communication Bulletins Reviewing list serve announcements If you are not already signed up for our Listserve we encourage you to sign up immediately. Please make note of the changes to this process that will be discussed later in the meeting.
17
18 Melinda Weissinger
19
20 Eastpointe Program Integrity will be conducting a face to face Fraud, Waste, Abuse (FWA) training to all contracted providers on the following topics: The Eastpointe PI Audit Process How to identify FWA within your agency Provider Self-Audit Process
21 Eastpointe Lumberton Site 450 Country Club Road Lumberton, NC April 25, 2107 from 10:00 am until 1:00 pm
22 Eastpointe Rocky Mount Site 500 Nash Medical Arts Mall Rocky Mount, NC April 27, 2017 from 10:00 am until 1:00 pm
23 Be on the look out for registration information that will be sent to the provider community via the listserve.
24 Tanisha Draughn, M.Ed.
25 In early 2000 it was determined that there was a lack of professionals legally qualified to carry out the first exam in the Involuntary Commitment process (IVC) especially in rural North Carolina. In 2003 the North Carolina General Assembly passed legislation approving a pilot project that allowed a licensed clinical social worker, a masters level psychiatric nurse, or a masters level certified clinical addictions specialist to conduct the initial (first level) examinations.
26 As a part of this pilot project, NASW-NC with the NC Psychological Association, the NC Psychiatric Association, the North Carolina Department of Health and Human Services (DHHS) Division of Mental Health and staff from numerous LME/MCOs developed a training and credentialing process for Licensed clinical social worker, Master s level psychiatric nurse and Master s level certified clinical addictions specialist. Effective 10/1/2011 the General Assembly gave permanent approval for LCWs, Master level psychiatric nurses and Master s level certified clinical addictions specialist to conduct the First Commitment Evaluation. (Session Law , senate bill 437)
27 The General Statues also state A physician shall be available at all times to provide backup support to include consultation and face to face evaluation if needed. This substitution in no way should be construed as authorization to expand the scope of practice of the LCSW, master s level LCAS or the master s level psychiatric nurse.
28 Candidates identified-lcsw, LCAS and Psychiatric Nurses Forms desk form Completed and submitted The Form desk verification form can be found: Provider/Information, Manuals & Forms/Forms First Commitment Waiver Notification Form Candidate will be approved or denied by LME-(Candidate and supervisor must be credentialed by Eastpointe MCO Supervisor must be MD, Physician, Psychologist Complete online Training and Testing Complete 3 Evaluations Candidate will be Deemed competent by their supervisor Candidate information will be sent to DHHS Certification is for 3 years
29 The State has collaborated with the Behavioral Healthcare Resource Program at UNC-CH School of Social Work to create a site that allows for people enroll into courses and then take the required exam.
30 Eastpointe will recommend the candidate after verification is complete BHRP (Behavioral Healthcare Resource Program) staff will create a username and password for the candidate and will send to them via . This will give them access to the online training materials. BHRP will notify Eastpointe that access has been granted to the candidate. The candidate will have unlimited access to the training material.
31 Candidate will notify Eastpointe Network Operations Department via that they are ready to take exam. Eastpointe notifies BHRP and BHRP staff registers candidate for exam. Eastpointe will give candidate date and time of exam and candidate will complete exam at the Eastpointe Rocky Mount site. After candidate begins exam, they have 2 hours to complete.
32 If the candidate passes the exam they will 1. Complete an evaluation 2. Receive a certificate of completion that will attest that they have satisfactorily passed the civil Commitment Exam for North Carolina.
33 The candidate must arrange a second attempt within 60 days. Should they fail a second time, they will need to wait for ninety days before being given the opportunity to retake the test one further time and continue with the First Commitment Process. If they fail a second time, they will then wait a year from the time of the second failed passing before given the opportunity to test again.
34 Once the candidate passes the exam they will complete 3 or more evaluations under the supervision of the identified supervisor.
35 & The statement must indicate the supervisors determination of the candidate s competence.
36 Once the Division has received the signed statement, the Division s Master List will be updated. An ID card will be generated for the candidate by Behavioral Healthcare Resource Program UNC-CH School of Social work and sent to Eastpointe for distribution.
37
38 First Commitment evaluations that deem the individual being examined as fit to be returned to the community require the First Commitment evaluator to call the supervising eligible psychologist or psychiatrist prior to the release. This is a safety check meant to safeguard the individual, evaluator and the supervisor.
39
40 Tanisha Draughn, M.Ed.
41 As we are all aware, the storm Hurricane Matthew impacted our Eastpointe provider network and members tremendously. During Hurricane Matthew, our Community Relations Department utilized the information received from the Disaster Shelter forms to reach out to providers and ensure the safety of our members. As a result, Eastpointe is reminding all providers to submit and/or update their Disaster Plan and Shelter Forms.
42 The Disaster Plans and Disaster Shelter Forms are required and were to be submitted upon the renewal of your IPRS contracts. If your Disaster Plans and Disaster Shelter Forms have not been submitted, please send updated copies of your plan and shelter form to Network Operations via fax or .
43 The updated Provider Participant for Disaster Shelter Form has been updated to include additional elements: Date form completed Indication of the counties where your sites are located. Signature of person completing form
44 The Disaster Shelter Forms are required and were to be submitted upon the renewal of your Medicaid contracts. If your agency's Disaster Shelter Forms have not been submitted, please send updated copies of the form to Network Operations via fax or .
45 A Disaster Plan Template is available as an example, but it is not mandatory to use this template. To locate the template, go to Provider > Manuals and Forms > Forms> Disaster Forms The Eastpointe Provider Participants for Disaster Shelter form is also located under Disaster Forms.
46 Both documents can be submitted via fax or . The fax number is and address is
47 Employment of Relatives/Legal Guardian as Providers Becky Womble, BS/QP/CI Provider Relations Specialist Network Operations
48 We are only accepting the current Verification of Relative Legal Guardian as Direct Support Employee (RDSE) Application RDSE Applications are only required for requested hours of over 40 hours/week, not to exceed 56 hours/week. (This includes both Primary and back-up combined.) Remember to submit RDSE Applications only for the Relative/Legal Guardian (Prospective Employee) who live in the same home as the member.
49 Ensure that all boxes are checked and all applicable questions are thoroughly answered. The Annual recertification section on 2 nd page only needs to be completed if Annual Recertification is checked on 1 st first page. The Relative as Provider Innovations Waiver Daily Schedule is required with all submissions
50 All RDSE Applications need to be mailed or hand delivered to Eastpointe- Network Operations 500 Nash Medical Arts Mall, Rocky Mount, NC nd or 3 rd submissions of RDSE Applications have up to 10 business days to be mailed or hand delivered from the date on the Unable To Process (UTP) letter. All RDSE forms are located on our website as follows: > Provider > Manuals and Forms > Forms > Relative As Provider.
51 Linda Hawley Isbell
52
53 It is your responsibility as a contracted provider to submit your Re- Credentialing application for yourself and for any performing providers. Please do not wait a week or so before the Credentialing expiration date to submit the application. This will cause a lapse in your Credentialing. Eastpointe sent out a courtesy letter 60 days prior to the expiration of your Credentialing. This is only a reminder. If you have received that letter you need to immediately submit your application to ensure that there is not a gap in your Credentialing.
54 If your Re-Credentialing is not completed prior to your Credentialing end date you will be end dated in Alpha and can no longer serve Eastpointe members. If you have any questions please contact Network Operations.
55
56 If there is a member who needs a specific Medicaid or state funded service for a specific period of time and there is not a provider in the network available to provide the needed service a Single Case Agreement (SCA) can be requested.
57 The new Single Case Agreement (SCA) form is submitted by the provider along with: The Electronic Funds Transfer Form (EFT), Trading Partner Agreement (TPA) Current Copies of Certificates of Insurance (COI) Copy of W-9 Copy of voided check or an official letter from the bank providing the account and routing numbers and A paper TAR if the requested service must be authorized. Copies of required licenses
58 Application is available in two formats: printable and web submission. Downloadable format Provider Manuals and Forms Forms Single Case Agreement. This format should be submitted via fax to or via secure to
59 Electronic submission format: Provider Manuals and Forms Electronic Forms Single Case Agreement. When using this format, the required documents listed under Attachment B should be uploaded to the application under the section provided for additional documents.
60 These documents are available on the Eastpointe website at Provider Manuals and Forms Forms. You should be able to save them to your desktop and once complete, they can be attached to both the Downloadable and/or Electronic Form. they can be attached to the formdesk form. them to your desktop and once complete, they can be attached to the formdesk form.
61 Medical necessity must be determined for services requiring pre-authorization before the SCA can be approved. Members should not be placed in a residential facility or receive services until the Single Case Agreement is approved. Provider will not receive payment for services until the SCA is approved and set up in Alpha.
62 This application is used to request both Medicaid and IPRS funded services. All questions on the application must be answered. Only submit for one member per application. Multiple services can be requested on the same application. Both the service and service code must be provided. Funding Source: Be sure to indicate if the requested service is for Medicaid or IPRS Funding.
63 SCA PROCESS Date: actual date the application is submitted to Eastpointe. Provider information on the application should be the same as the provider information in NC Tracks or the application will be determined Unable to Process (UTP). Required attachments (Section 10) must be submitted along with SCA. Zip codes require both the zip code and the plus 4.
64 Certificate of Insurance (COI) must be current. Provider is responsible for sending updated COI to Eastpointe. Insurance requirements are listed on the application under #5 of the terms of the executed Single Case Agreement. All applications require an original signature and signature date to prevent being determined Unable to Process. Incomplete applications cannot be processed.
65
66 Eastpointe can upload changes to NC TRACKS to add: 1. NPI 2. Taxonomy codes 3. Sites The turn around for this submission is hours if a Managed Change Request is not currently under review.
67 Please send the following information in writing on Agency Letterhead to Name of Agency- (name shown in NC TRACKS) Date of Request The letter needs to be signed and dated by the NC TRACKS Office Administrator (this must be identified and it is required that we have approval before we can proceed with uploading changes to NC TRACKS) address NPI Tax ID Effective Date Site address Zip plus 4 County Phone number Taxonomy Licensure type if applicable ( for Licensed clinicians) License number if applicable (for Licensed clinicians) Effective and end date If licensure is applicable (for Licensed clinicians) Provider Bed Type if applicable- (this applies to Residential Services) # of beds if applicable (applies to residential services)
68 If you are experiencing issues with NC TRACKS such as delayed processing time with a Manage Change Request (MCR) please networkoperations@eastpointe.net Please include the following information in the so we can better assist you. Name of Agency or LIP with TAX ID NPI Date the Manage Change Request was submitted to NC TRACKS MCR ID Number (reference number) top left side of the NC TRACKS Provider Enrollment Form MCR Description ( provider enrollment, add address, add taxonomy) Please indicate the status ( in review, approved, denied, unable to submit)
69 Provider reported issues will be documented on the NC TRACKS Issues log The NC TRACKS Issues log will be sent to the Division of Medical Assistance (DMA)every other week for review.
70
71 NC Medicaid Electronic Health Record Incentive Program Announcement. NCTRACKS Provider Training Available in February 2017 Re-Credentialing Due Dates for Calendar Year 2017 Affordable Care Act Fee Increase for Provider Enrollment Upload Documents in NCTracks Provider Portal
72 Upload Documents in NCTRACKS Provider Portal Medicaid and NC Health Choice Provider Fingerprint-based Criminal Background Checks
73
74 All Mental Health/Substance Abuse Providers (MH/SA) who provide enhanced services and basic benefit services and all Intellectual and Developmental Disability (IDD) Providers that provide assessments are required to maintain appointments on the Slot Scheduler. This includes Licensed Independent Practitioners (LIP) who have an LIP contract with Eastpointe.
75 The timeframe for follow-up completion depends on the triage and are as followed: Routine: within 24 hours of the scheduled appointment Example: If a routine appt is scheduled for August 1 st at 3:30pm, the followup is due no later than 3:30pm on August 2 nd. Urgent: by the end of the business day of the appointment date Example: If an urgent appt is scheduled for August 10 th at 3:30pm, the followup is due prior to provider closing on August 10 th.
76 Follow-up for any Saturday appointments should be completed no later than 9:00am on the following Monday. Example: If an appt is scheduled for Saturday, January 21st, the follow-up is due no later than 9:00am on Monday, January 23rd. If you have any questions about this process, you can reference the recorded webinar trainings completed by Network Operation and Member Call Center on the website
77
78
79 Utilize the Eastpointe Provider Change Form on our website. Please be sure to use the most up to date form that was revised. To locate the form go to our website then go to Provider then Manuals and Forms and then Forms then Updating Provider Information. Complete the Eastpointe Provider Change Form for Provider Directory and Alpha.
80
81
82
83 We are very interested in hearing from our Provider Community about topics that you would like us to discuss at upcoming meetings. We would like to make sure that we are covering topics of interest to our Provider Network. Please send those to Please indicate in the subject line : Provider Meeting Topics
84 This is a very important time to sign up for Listserve.
85 Directions for signing up for list serve: 1. Go to Eastpointe s website at 2. Click on Provider 3. Then click on Manuals and Forms 4. Then click on Listserve Announcements 5. Go to: Sign up to join the Eastpointe Listserve!
86 6. Enter your address (make sure you type it correctly), enter your first and last name, and agency 7. Click on the Sign Up button 8. After you sign up, a Thank you page will open. You have been added to the mailing list and can exit You will receive an that your request has been submitted
87
88 Please remember to register for Provider Meetings on our website Under Provider Community Then Calendar of Events Our next meeting is scheduled for April 19, 2017 from 10:00am until 1:00pm and this meeting will be a webinar.
89 Please contact Network Operations Call Center at (888) or Fax:
90 Member Call Center Fax: (910)
91 Visit our website to locate Communication Bulletins Manuals Provider Meeting PowerPoint s Provider Forms Training Announcements and Sign Up Provider Choice Database And so much more
TYPE OF CALL QUESTION ANSWER. from the CAQH database for the application process?
Can Sandhills Center pull information from the CAQH database for the application process? This is a brand new credentialing application process, the entire application must be completed. Are there any
More informationNorth Carolina Department of Health and Human Services NC Division of Medical Assistance - Program Integrity
02072011 North Carolina Department of Health and Human Services NC Division of Medical Assistance - Program Integrity BEHAVIORAL HEALTH: INDEPENDENT MH SA PROVIDER TOOL REVIEW GUIDELINES ADMINISTRATIVE
More informationThe Basics of LME/MCO Authorization and Appeals
The Basics of LME/MCO Authorization and Appeals Tracy Hayes, JD General Counsel and Chief Compliance Officer July 17, 2014 DSS Attorneys Summer Conference Asheville, NC What is Smoky Mountain? Area Authority
More informationProvider Frequently Asked Questions (FAQ)
1. What behavioral health services does Magellan of Virginia manage for Virginia Medicaid? Covered Services Magellan is responsible for management of the behavioral health services for the fee-for-service
More informationManaged Care Organizations (MCOs): The Basics and Emerging Issues. Who is Disability Rights NC?
Managed Care Organizations (MCOs): The Basics and Emerging Issues Disability Rights NC Conference 2015 Jennifer Bills, Senior Attorney Lisa Nesbitt, Attorney Who is Disability Rights NC? We are the protection
More informationIf you are credentialed and a contract is required for your network participation; the contract will be
We would like to thank you for your interest in enrolling as a Licensed Independent Practitioner ( LIP ) in the Cardinal Innovations Healthcare ( Cardinal Innovations ) provider network. Enrollment requires
More informationOutpatient Behavioral Health Basics 1
7/5/2018 1 Outpatient Behavioral Health Basics July 2018 Webinar 1 Description: This class will review the SoonerCare Outpatient Behavioral Health Program. It will include an overview of commonly asked
More informationCOUNSELING CREDENTIALS
COUNSELING CREDENTIALS The Board offers two levels of counseling credentials: a more experience-based certification and advanced licensure for those meeting the higher education requirements. LICENSED
More informationNorth Carolina Substance Abuse Professional Practice Board. Credentialing Procedures Manual
North Carolina Substance Abuse Professional Practice Board Credentialing Procedures Manual P.O. Box 10126 Raleigh, NC 27605 www.ncsappb.org 919-832-0975 Table of Contents Forward 3 OVERVIEW OF CREDENTIALING
More informationRelative as Provider NC Innovations Waiver
NC Innovations Waiver Webinar - January 25, 2013 & January 28, 2013 Updated May 2013 Serving Durham, Wake, Cumberland and Johnston Counties Background on the Policy CMS gives states the ability to choose
More informationICF-IID Provider Information Session
ICF-IID Provider Information Session Presented by: Alliance Behavioral Healthcare & Rubicon Management, Inc. January 29, 2013 Serving Durham, Wake, Cumberland and Johnston Counties Session Objectives Providers
More informationWell Sense Health PlanBehavioral Health Policy & Procedure Manual for Providers
BEACON HEALTH STRATEGIES Well Sense Health PlanBehavioral Health Policy & Procedure Manual for Providers ESERVICES www.beaconhealthstrategies.com November 2013 BEACON HEALTH STRATEGIES Provider Manual
More informationQuarterly Report. Ken Jones, CEO. Renewing the Mind, Restoring the Spirit 1 S T A N D 2 N D Q U A R T E R : J U L Y - D E C E M B E R
Quarterly Report B o a r d o f D i r e c t o r s R o b B o y e tt e - C h a i r Bladen Emery White Billy Ray Pait Columbus James Prevatte Paul Russ Duplin Rebecca Judge Kay Hinson Edgecombe Addie Carmon
More informationWhat are MCOs? (b)/(c) refers to the type of waiver approved by CMS to allow this type of managed care program. The
Advocating in Medicaid Managed Care-Behavioral Health Services What is Medicaid managed care? How does receiving services through managed care affect me or my family member? How do I complain if I disagree
More informationCritical Access Behavioral Health Agency (CABHA)
Critical Access Behavioral Health Agency (CABHA) Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services December 9, 2009 Michael Watson Assistant
More informationNC-TOPPS NORTH CAROLINA - TREATMENT OUTCOMES AND PROGRAM PERFORMANCE SYSTEM SFY IMPLEMENTATION GUIDELINES
NC-TOPPS NORTH CAROLINA - TREATMENT OUTCOMES AND PROGRAM PERFORMANCE SYSTEM SFY 2007 2008 IMPLEMENTATION GUIDELINES FOR SUBSTANCE ABUSE AND MENTAL HEALTH CONSUMERS Version 4.0, INTRODUCTION The North Carolina
More informationSubject to change. Summary only; does not supersede manuals and formal notices and publications. Consult and appropriate Partners
Subject to change. Summary only; does not supersede manuals and formal notices and publications. Consult www.partnersbhm.org and appropriate Partners for most recent information or with questions. Gain
More informationNorth Carolina Department of Health and Human Services
North Carolina Department of Health and Human Services Beverly Eaves Perdue, Governor Lanier M. Cansler, Secretary Division of Mental Health, Developmental Division of Medical Assistance Disabilities and
More informationTransition of Care Plan
Transition of Care Plan Overview and Purpose As a result of the Medicaid Managed Care Final Rules, particularly, 42 CFR 438.62, CMS requires states to have a transition of care plan in place to ensure
More informationJoining Passport Health Plan. Welcome IMPACT Plus Providers
Joining Passport Health Plan Welcome IMPACT Plus Providers Agenda Passport Behavioral Health Services Overview Steps to Joining Passport Health Plan s Network Getting a Medicaid Number Enrolling in the
More informationArkansas Department of Human Services
Arkansas Department of Human Services Stakeholder Webinar May 31, 2018 Agenda OBH Certification Update Billing Update ConnectCare Services Transition Plan Tier 2 and Tier 3 New Services Q&A OBH CERTIFICATION
More informationOutpatient Behavioral Health Basics 1
6/6/2018 1 Outpatient Behavioral Health Basics 2018 Spring Workshop 1 Description: This class will review the SoonerCare Outpatient Behavioral Health Program. It will include an overview of commonly asked
More informationNC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Comprehensive Case Management for AMH/ASU.
NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services Comprehensive Case Management for AMH/ASU Table of Contents 1.0 Description of the Procedure, Product, or Service...
More informationService Review Criteria
Client Name: SAR#: Administrative Review Process notes: When documenting call outs to provider, please document the call in a patient note in Alpha the day the call is made. tes should be coded as Care
More informationArkansas Provider E-News
Arkansas Provider E-News This Issue: August 2018 This newsletter alerts providers to upcoming changes and other information or procedural updates. Evidenced-Based Treatment Practices Independent Assessment
More informationMergers and Acquisitions
Mergers and Acquisitions Q: Can agencies or CABHAs without a credentialed site in the Alliance Network collaborate or merge with another provider that has a credentialed site in the Alliance catchment
More informationLong Term Care Nursing Facility Resource Guide
Long Term Care Nursing Facility Resource Guide September 2014 Table of Contents Section 1: Introduction and Overview Introduction... 4 Purpose and Organization of Long Term Care Nursing Facility Resource
More informationProspective Provider Information Form Organizational / Group Behavioral Health and Substance Use Providers
Prospective Provider Information Form Organizational / Group Behavioral Health and Substance Use Providers Please review our current provider network needs outlined on the Health Share of Oregon website
More informationPolicy Issuer (Unit/Program) Policy Number. QM QM Effective Date Revision Date Functional Area: Beneficiary Protection
Title: Staff Registration County of Sacramento Policy and Procedure Policy Issuer (Unit/Program) Policy Number QM QM-03-07 Effective 06-07-2005 Revision 02-15-2018 Functional Area: Beneficiary Protection
More informationNational Verifier Training: Eligibility. November 8, 2017
National Verifier Training: Eligibility November 8, 2017 1 Housekeeping Audio is available through your computer s speakers The audience will remain on mute Enter questions at any time using the Questions
More informationFCC Form 460 for Consortia
Healthcare Connect Fund Program FCC Form 460 for Consortia Rural Health Care Program I Healthcare Connect Fund Program 1 FCC Form 460 for Consortia Today s Speakers Paloma Costa RHC Program Outreach Camelia
More informationWelcome to a tutorial on the abstract submission process for the 2015 AGU Fall Meeting.
Welcome to a tutorial on the abstract submission process for the 2015 AGU Fall Meeting. Please take a few moments to review this tutorial and become oriented with the 2015 process. Table of Contents Before
More informationPROVIDER HOT SHEET. AMH Hot Sheet 1 P age
MECKLENBURG COUNTY Area Mental Health, Developmental Disabilities and Substance Abuse Services 429 Billingsley Rd., 2 nd Floor Charlotte, NC 28211-1098 PROVIDER HOT SHEET Mecklenburg County General Manager
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 06-09/17 REPLACED: 03/14/17 CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.1: PROVIDER REQUIREMENTS PAGE(S) 15
PROVIDER REQUIREMENTS A provider must be enrolled in the Medicaid Program and meet the provider qualifications at the time service is rendered to be eligible to receive reimbursement through the Louisiana
More informationCardinal Innovations Child Continuum of Care Philosophy. March 2014
Cardinal Innovations Child Continuum of Care Philosophy March 2014 Disclaimer Information provided in this presentation pertains only to the counties in the Cardinal Innovations Healthcare Solutions Region.
More informationCritical Time Intervention (CTI) (State-Funded)
Critical Time (CTI) (State-Funded) Service Definition and Required Components Critical Time (CTI) is an intensive 9 month case management model designed to assist adults age 18 years and older with mental
More information...,...,.., ,,...,...::.,-----'
SANTA BARBARA COUNTY ~ DEPARTMENT OF Behavioral Wellness ~ ~ A System of Care and Recovery Pa g e 1 of 10 Departmental Policy and Procedure Section Sub-section Policy Quality Care Management General Policy#
More informationBehavioral Health Provider Training: Program Overview & Helpful Information
Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused
More informationState-Funded Enhanced Mental Health and Substance Abuse Services
and and Contents 1.0 Description of the Service... 3 2.0 Individuals Eligible for State-Funded Services... 3 3.0 When State-Funded Services Are Covered... 3 3.1 General Criteria... 3 3.2 Specific Criteria...
More informationMassHealth Provider Billing and Services Updates & Upcoming Initiatives. Massachusetts Health Care Training Forum July 2011
MassHealth Provider Billing and Services Updates & Upcoming Initiatives Massachusetts Health Care Training Forum July 2011 Agenda I. MassHealth Updates/Resources & Upcoming MassHealth Initiatives II. Paper
More informationCODES: H0045-U4 = Individual Respite H0045-HQ-U4 = Group Respite T1005-TD-U4 = Nursing Respite-RN T1005-TE-U4 = Nursing Respite-LPN
CODES: H0045-U4 = Individual Respite H0045-HQ-U4 = Group Respite T1005-TD-U4 = Nursing Respite-RN T1005-TE-U4 = Nursing Respite-LPN (b)(3) Respite Children MH/ID/DD/SUD and Adults with Developmental Disabilities
More informationTrillium Provider Manual
Trillium Provider Manual DOING BUSINESS WITH TRILLIUM HEALTH RESOURCES AS A CONTRACTED NETWORK PROVIDER Page 2 of 92 PROVIDER MANUAL This document is available on the Trillium web site at www.trilliumhealthresources.org,
More informationNorth Carolina Medicaid Special Bulletin
North Carolina Medicaid Special Bulletin An Information Service of the Division of Medical Assistance Visit DMA on the Web at http://www.ncdhhs.gov/dma September 2016 This is the first article in a two-part
More informationPsychiatric Residential Treatment Facility (PRTF) Prior Authorization Request
MIS# Name: Address: City/State/Zip: Phone #: Fax #: Client Information: Psychiatric Residential Treatment Facility (PRTF) Prior Authorization Request Clinical Contact Information * * * * Attachments *
More informationCERTIFIED SUBSTANCE ABUSE PREVENTION CONSULTANT (CSAPC)
CERTIFIED SUBSTANCE ABUSE PREVENTION CONSULTANT (CSAPC) This credential is offered to those persons whose primary responsibilities are to provide prevention/education, alternative activities, community
More informationKEY PERFORMANCE INDICATORS
KEY PERFORMANCE INDICATORS 2.1 GCAL When GCAL makes a referral for a non-enrolled individual with urgent needs, what is the average time between referral and first appointment? Should not exceed 24 hours
More informationMedical Assistance Provider Incentive Repository. User Guide. For Eligible Hospitals
Medical Assistance Provider Incentive Repository User Guide For Eligible Hospitals February 25, 2013 Contents Introduction... 3 Before You Begin... 3 Complete your R&A registration.... 3 Identify one individual
More informationProvider Additions and Demographic Maintenance Reference Guide
Table of Contents Introduction... 3 Anthem public provider website... 3 Council for Quality Affordable Healthcare (CAQH )... 3 Providers Requiring Credentialing Medical... 4 Facilities and Health Delivery
More informationCRISIS AND INPATIENT SERVICES
APRIL 2016 CRISIS AND INPATIENT SERVICES State Authorization: S.L.2008-107 (House Bill 2436), Part X, Section 10.15 (l) (m); S.L. 2009-451 (Senate Bill 202), Part X, Section 10.12(b); S.L. 2014 (Senate
More informationMEDICAID PRIOR AUTHORIZATION TRANSITION
MEDICAID PRIOR AUTHORIZATION TRANSITION Prepared for: Mississippi Medicaid Providers of - Psychological, Neuropsychological and Developmental Testing November, 2013 December 1, 2013 The Road Ahead 2 Today
More informationTITLE 17. PUBLIC HEALTH DIVISION 2. HEALTH AND WELFARE AGENCY CHAPTER 3. COMMUNITY SERVICES SUBCHAPTER 24. ENHANCED BEHAVIORAL SUPPORTS HOMES
TITLE 17. PUBLIC HEALTH DIVISION 2. HEALTH AND WELFARE AGENCY CHAPTER 3. COMMUNITY SERVICES SUBCHAPTER 24. ENHANCED BEHAVIORAL SUPPORTS HOMES 59050. Definitions. The following definitions shall apply to
More informationDIVISION OF HEALTHCARE FINANCING CMS 1500 ICD-10. October 1, 2017
DIVISION OF HEALTHCARE FINANCING CMS 1500 ICD-10 October 1, 2017 General Information Overview Thank you for your willingness to serve clients of the Medicaid Program and other medical assistance programs
More informationPersonal Care Services (PCS): An Overview of PCS and The Request for Independent Assessment for PCS Attestation of Medical Need Form (DMA 3051)
Personal Care Services (PCS): An Overview of PCS and The Request for Independent Assessment for PCS Attestation of Medical Need Form (DMA 3051) January 2018 OBJECTIVES At the conclusion of this training,
More informationMEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE
MEDICAL ASSISTANCE BULLETIN COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE SUBJECT BY NUMBER: ISSUE DATE: September 8, 1995 EFFECTIVE DATE: September 8, 1995 Mental Health Services Provided
More informationKEY PERFORMANCE INDICATORS
KEY PERFORMANCE INDICATORS GCAL Hospital Discharge 2.1 2.2 GCAL referrals for non-enrolled individuals with urgent needs are scheduled for an appointment within one (1) business day of referral. The 3.1
More informationSoonerCare Master Provider Numbers and Individual Rendering Provider Information
SoonerCare 2011 Outpatient Behavioral Health Agency Master Provider Numbers and Individual Rendering Provider Information 1 Upcoming changes in 2011 for OPBH agencies will be discussed: 10/01/2011: Master
More informationNew provider orientation. IAPEC December 2015
New provider orientation IAPEC-0109-15 December 2015 Welcome 2 Agenda Introduction to Amerigroup Provider resources Preservice processes Member benefits and services Claims and billing Provider responsibilities
More informationCommunity Care Health Plan Continuity of Care Policy
Community Care Health Plan Continuity of Care Policy Policy: 2.03a Origination Date: 02/2016 Last Review Date: 02/2016 Purpose: To ensure continuity of care (COC) for members when: Their Primary Medical
More informationNew Medicaid EHR Incentive Program Attestation System Overview. September 21, 2017 Kelly Hernandez Medicaid EHR Incentive Program Coordinator
New Medicaid EHR Incentive Program Attestation System Overview September 21, 2017 Kelly Hernandez Medicaid EHR Incentive Program Coordinator 1 Agenda Timeline What is changing with new portal How to access
More informationSOUTH CAROLINA DEPARTMENT OF TRANSPORTATION Office of Public Transit. Grants Management System (GMS) User Guide
SOUTH CAROLINA DEPARTMENT OF TRANSPORTATION Office of Public Transit Grants Management System (GMS) User Guide Table of Contents User Accounts... 3 Create User Accounts... 3 Login Procedure... 3 Annual
More informationRegistered Dietician (Individual)
PROVIDER TYPE SPECIFIC PACKET/CHECKLIST (Louisiana Medicaid Program) Registered Dietician (Individual) (Enrollment packet is subject to change without notice) GENERAL INFORMATION FOR THE INDIVIDUAL REGISTERED
More informationCayuseIRB Quick Start Guide for Researchers
1 CayuseIRB Quick Start Guide for Researchers 2 Table of Content What is CayuseIRB.. 2 Logging In.. 4 Dashboard. 6 Creating an New Study/Initial Review Request 7 Completing Your Protocol..11 Reviewing
More informationNC Medicaid and NCHC Bulletin April 2017
NC Medicaid and NCHC Bulletin April 2017 Avoiding Common Pitfalls with Medicaid Claims An article in the February 2016 Medicaid Bulletin, Payment Error Rate Measurement (PERM) covered aspects of the Centers
More informationGetting Started: Creating a New Account and Logging In
Getting Started: Creating a New Account and Logging In Welcome to Meals on Wheels America s Online Grant System! Meals on Wheels America will only accept grant applications and follow-up reports that are
More informationPURPOSE CONTACT. DHS Financial Operations Division (651) or or fax (651) SIGNED
Bulletin NUMBER #17-32-08 DATE March 20, 2017 OF INTEREST TO County Directors SSTS Coordinators Social Services Supervisors and Staff Fiscal Supervisors ACTION/DUE DATE Please read information and prepare
More informationCalifornia State University, Fullerton Clinical Mental Health Counseling with a Specialty in Marriage and Family Therapy
Student s Name CWID# Page 1 of 8 Please attach a photograph of yourself (passport size) at the time you submit this to the Counseling Department, Clinical Training Director. Attach head and shoulder photo
More informationCRISIS SERVICES. N. C. Department of Health and Human Services Division of Mental Health, Developmental Disabilities and Substance Abuse Services
APRIL 2012 CRISIS SERVICES State Authorization: G. S. 122C-147.1; S.L. 2006-66 (Senate Bill 1741), Part X, Section 10.26 (a) - (f); S.L. 2007-323 (House Bill 1473), Part X, Section 10.49; S.L.2008-107
More informationAttach head and shoulders photo here (affix with tape or staple only; do not use glue)
Please attach a photograph of yourself (passport size) at the time you submit this to the MACLP Clinical Training Department. Attach head and shoulders photo here (affix with tape or staple only; do not
More informationThis change effects ALL individuals holding a NCC credential, including RNC-E and those newly certified.
2018 Subspecialty Maintenance LEGACY Breastfeeding Gynecologic Reproductive Health Menopause Clinician Menopause Educator Obstetrics for the Primary Care Nurse Practitioner Effective January 1, 2016 --
More informationPROVIDER TYPE SPECIFIC PACKET/CHECKLIST
PROVIDER TYPE SPECIFIC PACKET/CHECKLIST (Louisiana Medicaid) Assistive Devices (Enrollment packet is subject to change without notice) Revised 03/15 GENERAL INFORMATION FOR PROVIDER ENROLLMENT Provider
More informationOrganizational Provider Credentialing Application
Organizational Provider Credentialing Application New Mexico Organizational provider identification Legal business name (as reported to the IRS): Medicaid number: Doing Business As (DBA) name (if applicable):
More informationILLINOIS NURSE ASSISTANT / HOME HEALTH AIDE COMPETENCY EXAM GUIDELINES FOR ILLINOIS NURSE ASSISTANT / AIDE PROGRAM COORDINATORS / INSTRUCTORS
ILLINOIS NURSE ASSISTANT / HOME HEALTH AIDE COMPETENCY EXAM GUIDELINES FOR ILLINOIS NURSE ASSISTANT / AIDE PROGRAM COORDINATORS / INSTRUCTORS SIUC Nurse Aide Testing Program and Illinois Department of
More informationThe North Carolina Mental Health and Substance Abuse Workforce
The North Carolina Mental Health and Substance Abuse Workforce Erica Richman, PhD, MSW Erin Fraher, PhD, MPP & Katie Gaul, MA Program on Health Workforce Research & Policy Cecil G. Sheps Center for Health
More informationADMINISTRATIVE GUIDELINES AND INTERPRETATIONS FOR THE NATIONAL LETTER OF INTENT (SIGNED DURING THE SIGNING PERIODS)
ADMINISTRATIVE GUIDELINES AND INTERPRETATIONS FOR THE 2018-19 NATIONAL LETTER OF INTENT (SIGNED DURING THE 2017-18 SIGNING PERIODS) THE BASICS: APPLICABLE NLI SPORTS: An institution may only issue National
More informationMAXIMUS Webinar Series
MAXIMUS Webinar Series What the Provider Enrollment Rule Means Operationally for States and MCOs, Including Network Adequacy Continuing the Discussion on the CMS Rule for Medicaid & CHIP Managed Care June
More informationAn Overview of ProviderConnect. May 2016
An Overview of ProviderConnect May 2016 Key Topics Services and Benefits Registering Benefits and Eligibility Search Authorizations and Claims Search Provider Summary Vouchers Recredentialing and Demographic
More informationInpatient and Residential Psychiatric Treatment Services. October 2017
Inpatient and Residential Psychiatric Treatment Services October 2017 Overview Provider Participation Requirements Member Eligibility Service Authorization Evaluation, Certificate of Need and Plan of Care
More informationBehavioral Health Provider Training: Program Overview & Helpful Information
Behavioral Health Provider Training: Program Overview & Helpful Information Overview The Passport Behavioral Health Program provides members with access to a full continuum of recovery and resiliency focused
More informationBehavioral Health Provider Training: BHSO updates
Behavioral Health Provider Training: BHSO updates Agenda Diagnosis Code 799 Laboratory Work CPT Code Q3014- Telehealth BHSO Claims submission Process Targeted Case Management Diagnosis Codes Diagnosis
More informationA SUMMARY OF MEDICAID REQUIREMENTS AND RELATED COA STANDARDS
A SUMMARY OF MEDICAID REQUIREMENTS AND RELATED COA STANDARDS This tool is intended to provide a broad overview of common Medicaid (MA) requirements in relation to COA s Standards. While there are specific
More informationMedical Assistance Provider Incentive Repository. User Guide. For Eligible Hospitals
Medical Assistance Provider Incentive Repository User Guide For Eligible Hospitals February 25, 2013 Contents Introduction...1 Before You Begin...2 Complete your R&A registration... 2 Identify one individual
More informationProvider Communications Plan
Provider Communications Plan Sandhills Center promotes and encourages open channels of communication and active participation with the provider network in order to: ensure that providers are aware of information
More informationDEFINITIONS: No show: any appointment whereby the patient fails to show or does not call 24 hours prior to the appointment to reschedule.
Policy and Procedure Outpatient Services SUBJECT/TITLE: PURPOSE: To ensure that clients/patients have access to services when needed by maximizing the utilization of available appointments. To provide
More informationNETWORK ADEQUACY OF SPECIALIZED BEHAVIORAL HEALTH PROVIDERS OFFICE OF BEHAVIORAL HEALTH LOUISIANA DEPARTMENT OF HEALTH
NETWORK ADEQUACY OF SPECIALIZED BEHAVIORAL HEALTH PROVIDERS OFFICE OF BEHAVIORAL HEALTH LOUISIANA DEPARTMENT OF HEALTH PERFORMANCE AUDIT SERVICES ISSUED OCTOBER 18, 2017 LOUISIANA LEGISLATIVE AUDITOR 1600
More informationProvider Network Capacity, Needs Assessment and Gaps Analysis
Provider Network Capacity, Needs Assessment and Gaps Analysis 2016 This study assesses the Cardinal Innovations Healthcare community to determine needs and capacity of providers to deliver services. This
More informationIRIS Tips and Updates. Department of Health and Human Services DMH/DD/SAS Stacie Forrest and Glenda Stokes
Department of Health and Human Services DMH/DD/SAS Stacie Forrest and Glenda Stokes IRIS Resources 2 Who Must Report? Any provider of publicly funded services licensed under NC General Statutes 122C, except
More informationMental Health Rehabilitation Authorization Resource Kit
Mental Health Rehabilitation Authorization Resource Kit CONTENTS Introduction... 2 Provider Notice 2018-27: Revised and Streamlined MHR Authorization Process... 3 Process Overview & Submission Checklist...
More informationFREQUENTLY ASKED QUESTIONS FOR PROVIDERS
FREQUENTLY ASKED QUESTIONS FOR PROVIDERS TN PASRR REIMPLEMENTATION DEVELOPED: 10.5.16 REVISED: 10.17.16 Contents PASRR... 1 1. Does the person have to have be in TN to submit a PASRR?... 1 2. When does
More informationInteractive Voice Registration (IVR) System Manual WASHINGTON STREET, SUITE 310 BOSTON, MA (800)
Interactive Voice Registration (IVR) System Manual 1000 WASHINGTON STREET, SUITE 310 BOSTON, MA 02118-5002 (800) 495-0086 www.masspartnership.com TABLE OF CONTENTS INTRODUCTION... 3 IVR INSTRUCTIONS...
More informationLTC User Guide for Nursing Facility Forms 3618/3619 and Minimum Data Set/ Long Term Care Medicaid Information (MDS/LTCMI)
LTC User Guide for Nursing Facility Forms 3618/3619 and Minimum Data Set/ Long Term Care Medicaid Information (MDS/LTCMI) v 2018 0614 Contents Learning Objectives...1 Sequencing of Documents...2 Admission
More informationRequest for Proposal FOR SCHOOL-BASED THERAPY SERVICES MAY 1, 2018
Request for Proposal FOR SCHOOL-BASED THERAPY SERVICES MAY 1, 2018 This solicitation should not be interpreted as a contract (implicit, explicit, or implied), nor does it imply any form of agreement to
More informationTransition to Community Living Initiative Diversion Process PASRR Manual for Adult Care Homes Licensed Under GS 131D 2.4
Transition to Community Living Initiative Diversion Process PASRR Manual for Adult Care Homes Licensed Under GS 131D 2.4 Presenters : Johnnie McManus, PASRR Coordinator 1 Introduction Pre-Admission Screening
More informationRequest for Proposal TRANSITIONAL HOUSING AUGUST 31, 2018
Request for Proposal TRANSITIONAL HOUSING AUGUST 31, 2018 This solicitation should not be interpreted as a contract (implicit, explicit, or implied), nor does it imply any form of agreement to any potential
More informationApplicant User Guide
Office of Certification and Professional Preparation Process for Online Initial Teaching Applications (Form 20T) Applicant User Guide Last Updated 4/21/2016 The West Virginia Department of Education, Office
More informationConflict of Interest Committee Submission Guide
Conflict of Interest Committee Submission Guide Training materials for using IRBNet are available at: http://www.irbnetresources.org/ (userid: kettering, password: training) Guides and submission forms
More informationKDHE-DHCF: Kansas Department of Health and Environment - Division of Health Care Finance. UM Retrospective Review Services.
KDHE-DHCF: Kansas Department of Health and Environment - Division of Health Care Finance UM Retrospective Review Services Provider Manual August 2017 This page intentionally blank Table of Contents KDHE-DHCF:
More informationChild Care Provider Preparation Guide
Child Care Provider Preparation Guide North Carolina Department of Health and Human Services Families Accessing Services through Technology (NC FAST) September 2017 Version 10.0 Page 1 of 17 Document Change
More informationBCBS NC Blue Medicare Credentialing Instructions
BCBS C Blue Medicare Credentialing Instructions Licensed Certified Social Worker (LCSW) Certified Substance Abuse Counselor (CSAC) Licensed Clinical Addiction Specialist (LCAS) Licensed Marriage and Family
More informationWelcome to a tutorial on the abstract submission process for the 2014 AGU Fall Meeting.
Welcome to a tutorial on the abstract submission process for the 2014 AGU Fall Meeting. NOTE: The abstract submission site is NEW this year. Please take a few moments to review this tutorial and become
More informationNursing Home and Hospice Billing Training Presented by Field Representatives Kinzie Baker & Liz Lovell-Poynor
Nursing Home and Hospice Billing Training 2018 Presented by Field Representatives Kinzie Baker & Liz Lovell-Poynor Wyoming Medicaid General Manual Chapter 1- General Information Chapter 2-Getting Help
More information