A webinar called “Using the CSRS like a Pro” will be held Wednesday, March 20., 2019 from 12:30-1:20pm via Zoom. Get more information and register.
Innovations providers should note that there are changes to the out of state travel notification process and form. Effective March 18, 2019 Alliance is changing the form and procedure for PIHP approval of out-of-state travel for Innovation members. Please access the form here, complete it and sign to document agency supervisory or agency of choice approval. Submit the form to [email protected]. Alliance will review and return an Alliance-signed copy.
Effective January 1, 2019, the American Psychological Association (APA) has released updated CPT codes for Developmental, Psychological and Neurological testing. You may refer to https://www.apaservices.org/practice/reimbursement/health-codes/testing for additional information and also review the January NC Medicaid Bulletin for additional reference.
As a result of the change the following Medicaid and state testing codes have been replaced and are end-dated effective December 31, 2018: 96101, 96111 and 96118. The new testing codes that have been added for Medicaid services effective January 1, 2019 are: 96112, 96113, 96121, 96130, 96131, 96132, 96133, 96136, 96137, and 96146. Please see Alliance Medicaid Rate sheet https://www.alliancehealthplan.org/wp-content/uploads/Medicaid-Rate-Sheet-Jan-2019.pdf.
As indicated in the earlier communications, Alliance Health will work with providers around retrospective claims and authorization requests for services. In order to be considered for retrospective authorizations and payment, please submit any retrospective authorization requests for these codes by April 30, 2019. Any claims related to the retrospective authorizations for psychological testing codes will need to be submitted no later than May 31, 2019.
Contract amendments are in the process of being sent to all affected providers via Docusign.
Alliance Health is re-releasing a previously released RFP for Critical Time Intervention in Wake County with changes in program elements and funding. Previous applicants do not need to reapply.
Alliance has updated the Provider Application Request form. Please use this form for all requests.
The IRIS website will be unavailable while an update is installed on Tuesday, February 19, from 7 to 9 am.
IRIS reports are due within 72 clock hours from the time that the provider learns of an incident. If needed, Providers may obtain a hard copy of the report from the IRIS website (https://iris.dhhs.state.nc.us/) before February 18th and submit the report to the LME-MCO (Host and Home) and DMH/DD/SAS Customer Service and Community Rights Team via fax within specified timeframes and procedures. Providers will still need to enter the report into IRIS once the system is available. The fax number for Customer Service and Community Rights Team is 919-733-4962. Reports to be filed with DHSR Healthcare Personnel Registry should be submitted to HCPR within specified timeframes at 919-733-3207. Reports regarding Deaths (suicide, homicide/violence, accident or restraint) in a licensed facility should be reported to DHSR Complaint Intake Unit and can be faxed to 919-715-7724. We apologize for any inconvenience. Thank you for your assistance.
Alliance initiated a quality improvement project called UM Expedite Care with a goal of reducing the turn-around time for authorization requests involving youth discharging from inpatient or emergency department settings. Providers delivering post-acute stabilization services that require prior authorization can submit an expedited authorization review for youth discharging from these settings. Alliance has created a webinar that explains in more detail the criteria for requesting the expedited reviews. You may access the webinar here: alliancebh.academy.reliaslearning.com/Expedited-Request-Training–735146.aspx.
If you have any problems accessing the training, please contact Relias IT Support at (844) 735-2223.
Alliance is excited to present the new and improved Provider Maintenance Application. The Provider Maintenance Application will serve as a way for providers to maintain and update information on their credentialed sites, specialties and ability to accept referrals. This is only phase one of the portal and as Alliance continues to develop and grow the information contained within the portal, this application will provide information into Alliance’s Provider Directory for members, stakeholders, and providers to use when helping Alliance members research treatment options and access treatment.
Providers who have not already created a profile should do so, and include information outlining their ability to accept referrals by funding source, for each identified site, service and specialty. Providers will be able to update their ability accept referrals for these categories, in real time, by updating their profiles in the application.
To access the application, providers may log in at: https://portal.alliancebhc.org/Login/. Providers will see in the upper right corner area a User Guide which may also be accessed via this link: https://portal.alliancebhc.org/Documents/Provider%20PORTAL%20User%20Guide_V1.0.pdf.
Through participation in the Provider Maintenance Application, providers will be able to keep Alliance informed of their ability to accept referrals for specific services, or at specific locations. Providers with updated profiles will be eligible to receive referrals directly from Alliance departments including Access and Care Coordination. Information collected through the portal will also be used to inform network adequacy and capacity. Questions about the Provider Maintenance Referral Application can be directed to Alliance’s Provider Helpdesk ([email protected]) or to Provider Network Development Specialist Melissa Payne at [email protected] or 919-651-8801.
This portal is also used for reporting provider accreditation status. All accredited (CARF, CQI, The Joint, COA) are required to inform Alliance of their accreditation status. If you have any questions regarding the use of the portal please contact Melissa Shaffer at (919) 812-9906 or email [email protected].
Providers are expected to enroll in the system, and review the information contained within their profile no later than January 31, 2019. All providers enrolled in the system are strongly encouraged to also review and update their profiles, especially their ability to accept referrals, on a routine basis, and at minimum every 90 days.
Alliance will create and post a webinar training to the Alliance website for providers during the first quarter of 2019. When it is completed providers will be informed of where to find it on the Alliance website.
NC DHHS announced today that contracts to operate statewide Standard Plans were awarded to AmeriHealth Caritas NC, BCBSNC, UnitedHealthcare of NC and WellCare of NC. Additionally, a regional contract was awarded to Carolina Complete Health, a provider-led entity, to operate in two of the state’s five regions. More information is available here.
Access and Information Center:
We want to make it easy for you to get the services or information you need. You can call the Alliance Access and Information Center toll-free 24 hours a day.
Representatives are available 8:30am-5:15pm Monday-Friday to answer provider questions about authorization, billing, claims, enrollment and credentialing, the Alpha Provider Portal or other issues.
Confidential Fraud and Abuse Line:
You are encouraged to report matters involving Medicaid fraud and abuse. If you want to report fraud or abuse, you can remain anonymous. Learn more.
Alliance maintains community offices in Durham, Wake, Cumberland and Johnston counties. Addresses and directions to the Alliance offices.