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1 Maryland enewsletter May 2016 Welcome to the new Beacon Maryland Newsletter Beacon Health Options has designed this new quarterly publication to assist providers in getting the news out to the Maryland Medicaid provider/ program community. Some of the information will be new and some will be important repeats of Provider Alert information sent out recently. We are also looking for any comments/suggestions on topics that may be of interest. In this Issue: Please feel free to send thoughts to: Behavioral Health Services: Role of an Administrative Service Organization We hope you enjoy this. Karl Steinkraus Provider Services Quality Management Program Integrity Highlights Provider Q&A Upcoming Webinars & Training Director, Provider Relations Beacon Health Options 1
2 programs. The following services are covered in Maryland: Role of an Administrative Services Organization Mental Health hospitalization; Beacon Health Options is the Administrative Service residential treatment for children and adolescents; Organization (ASO) for the Public Behavioral Health individual therapy; System for the state of Maryland. Beacon administers group therapy; numerous aspects of the public behavioral health system mental health targeted case management; including: family psychotherapy and psychoeducation; participant education; psychiatric rehabilitation; service authorization and utilization management; psychological testing; participant and provider assistance and assertive community treatment; communication; quality management and evaluation; mobile treatment; provider and participant appeals and grievances; partial hospitalization; claims processing and payment; intensive outpatient program services; and data capabilities; and laboratory services. special projects, such as data analytic reports. Behavioral Health Services: Substance Use Beacon Health Options is also responsible for coordinating alcohol and/or drug assessment; with both local agencies and the managed care individual outpatient therapy; organizations to ensure appropriate referrals and group outpatient therapy; coordination between managed care organizations and partial hospitalization; behavioral health providers. ambulatory detoxification; Suboxone treatment opioid maintenance therapy for individuals 18 and Maryland has incorporated a wide array of mental health and substance use services into its Medicaid and grants over; 2
3 medically monitored intensive inpatient treatment; medically monitored inpatient detoxification for individuals under 21 years; child and adolescent residential services; and laboratory services Non-Medicaid reimbursable behavioral health services are also available to qualifying individuals. Among other things, these services include supported employment, respite care, crisis services, peer support, recovery services, and residential rehabilitation programs. These services are administered through Beacon Health Options via other funding sources overseen by the Department of Health and Mental Hygiene s Behavioral Health Administration (Behavioral Health Services Overview, December 2015, Volume Four, Issue One). For more information on Beacon Health Options please visit: Provider Services Beacon Health Options Provider Relations, Core Service Agencies and Local Addiction Authorities offer outreach, training, education, technical assistance, provider communication and problem resolution to providers in our network. Important Provider Alerts Eligibility Re-Determination Report (Report assists providers with tracking a consumer eligibility status for Maryland Medicaid.) Eligibility-Re-Determination-Report pdf Retroactive Authorization Requests Reminder (Review requests for retrospective authorization only in cases where a participant has gained retroactive Medical Assistance benefits.) Retroactive-Authorization-Requests-Reminder pdf Guidelines for Discharge of Substance Related Disorder Clients Guidelines-for-Discharge-of-Substance-Related- Disorder-Clients pdf Discharge Workflow-Substance Related Disorder Clients Discharge-Workflow-Substance-Related-Disorder- Clients pdf Transition to Fee-For-Service (substance use disorder) Transition-to-Fee-for-Service pdf Substance Use Disorder Data Dictionary alerts/2016/sud-data-dictionary pdf Substance Use Disorder and Uninsured/Grant Funded Individuals SUD-Uninsured-Grant-Funded-Individuals pdf Telehealth Program Updates (Combing Telemedicine and Telemental Health Programs) Telehealth-Program.pdf 3
4 Overdose Response Program Naloxone Training (online calendar where members of the public can locate local naloxone training events) alerts/2016/overdose-response-program-naloxone- Training pdf Upcoming Provider Alerts! Provider Council Meeting (2nd Friday of each month) NPI Match reminder Release of Information reminder To access additional and archived Provider Alerts visit: Quality Management Administrative Service Organization (ASO) Complaint Process Complaints can be submitted by fax, , correspondence, or telephone. Beacon Health Options Maryland investigates billing complaints against the ASO. Designees of the Behavioral Health Administration (BHA) investigate complaints against providers such as Access to Care, Medication and Unprofessional Behavior. Grievances When a request for authorization is denied for a lack of medical necessity the provider and/or consumer may choose to request a grievance. In order to request a grievance please call (410) and give the pertinent information such as the consumer name, provider name, level of service, number of units and date span being grieved. Program Integrity Compliances Presents Maryland Register Online! This is an official publication of the State of Maryland and is published every two weeks. The Register serves as the temporary supplement to the Code of Maryland Regulations (COMAR). Any change to the text of regulations published in COMAR, whether by adoption, amendment, repeal, or emergency action, must first be published in the Register MDR/mdregister.html. 3
5 Highlights Achieve Solutions: featured topic, Schizophrenia: What is it? Beacon White Paper Release: Integration (PDF) Beacon White Paper Release: Confronting The Crisis of Opioid Addiction June Provider Alert: Telehealth Program Updates Data Shorts: Six Months of Behavioral Health Adult Outpatient Claims January 2016, VOL.5, Issue 2 alerts/2016/data-shorts-volume5-issue2.pdf Provider Q&A The Provider Q&A section allow providers in our network to get involved, ask questions, and learn. Please submit your questions to be answered in our next quarterly enewsletter to address: marylandproviderrelations@beaconhealthoptions.com 4
6 UPCOMING WEBINARS Spring 2016 ProviderConnect These webinars are designed to review our system and support the E-Commerce Initiative for network providers. Online: Provider Connect for Mental Health Providers 06/08/16 10:00 am- 11:00 am EST Webinar: Online Forum 1) To Register go to: rt/ ) You will then be prompted to enter registration information. 3) A confirmation with both the call in number and webinar instructions will be ed to you after you successfully registered. Online: Provider Connect for Substance Use Disorder Providers 06/16/16 10:00 am- 12:00 pm EST Webinar: Online Forum 1) To Register go to: rt/ ) You will then be prompted to enter registration information. 3) A confirmation with both the call in number and webinar instructions will be ed to you after you successfully registered. 5
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