Alliance Brand A

A Public Statement from the Leadership of Alliance Health

We offer these heartfelt sentiments about the events that have evolved across the country over the past few days stemming from the horrific act of violence against an unarmed black man, George Floyd. The violence that has occurred in the wake of peaceful protests across the country is frightening and hopefully will come to an end soon, and meaningful conversations about race and inequities can begin.

We respectfully acknowledge that as white men our experiences do not allow us to fully identify with what some of our neighbors are dealing with or feeling. What we do know is that everyone deserves to be treated fairly and with kindness and respect, and to be able to live without fear.

As you can imagine, there is a myriad of emotions being experienced by the staff of Alliance Health and the people we serve as members of our health plan. Each is experiencing their own unique set of feelings and we want to assure them that Alliance stands behind each of them. For our staff, we want to do everything we can to ensure that we offer a workplace environment that truly understands and appreciates diversity and cultural competency. Our Alliance staff are of the upmost importance to us and are the greatest strength of this organization. We do know that if our staff are hurting, we are in no position to help others.

Our leadership team is committed to ensuring that we at Alliance do better, and our company is actively researching and identifying additional resources and strategies to increase our understanding and empathy, to expand our perspectives, and to more fully support each other. Moreover, Alliance’s Board has voted unanimously to review and revise the organization’s Code of Ethics to include stricter expectations of itself and our employees and management with regard to matters of racism and racist acts.

We are proud to be part of an organization whose Board and staff are dedicated to helping all who find themselves in need. At Alliance, we stand resolute in our values of diversity and inclusivity and denounce all forms of racism. It is important now, as it has always been, that we fulfill our mission and values and continue to help improve the lives of those who are in the greatest need, and that we strive to do it in the most inclusive and accepting way.

With hope for the future,

Rob Robinson
Chief Executive Officer

Gino Pazzaglini
Chair, Board of Directors

 Special Bulletins: COVID-19 #75 & 76 Behavioral Health Service Flexibilities

The Division of Health Benefits (NC Medicaid) issued Special Bulletins COVID-19 #75 & 76
Behavioral Health Service Flexibilities– Innovations and TBI Waivers’ Appendix K and Developmental Disability State-Funded Benefit Plans. These codes were added to Medicaid and State contracts for existing Innovation, TBI, and IDD Providers as outlined below.

Providers will be required to utilize the codes/modifiers for any of the service flexibilities that are being provided with service dates starting on and after June 15, 2020.  However, the codes are currently active in Alpha, and providers can choose to use the codes prior to June 15, 2020, as their billing systems allow.

Important to Note: 

  • Providers that will deliver these services via audio/visual to COVID-19 must add both modifiers (GT and CR) to the code when submitting for reimbursement(for codes that have this flexibility).
  • If the services are delivered telephonically only, then the provider will only use the CR code (for codes that allow for this flexibility).

Providers that have submitted claims prior to this notification will not be required to resubmit claims at this time.  Providers are required to use the GT CR and CR modifiers to COVID related service delivery with claims submitted with dates of service no later than June 15, 2020.

Contract amendments will not be sent out regarding these codes but will be included in your FY21 contracts.  Providers can verify codes added to their contracts by reviewing their Alpha set up.  If you feel you are missing a code that should be in your contract please contact [email protected] for assistance.

List of Codes

COVID-19 #75: https://medicaid.ncdhhs.gov/blog/2020/05/01/special-bulletin-covid-19-75-telehealth-and-virtual-patient-communications-clinical

COVID-19 #76: https://medicaid.ncdhhs.gov/blog/2020/05/01/special-bulletin-covid-19-76-telehealth-and-virtual-patient-communications-clinical

Please direct any questions or concerns to [email protected].

Alliance Health highly recommends that you monitor Provider News and our website daily for any updates regarding provider services. Alliance will update this information as we receive any updates from the State in regards to COVID-19.

Please continue to check our COVID-19 resources for providers at alliancehealthplan.org/providers/covid-19-updates-and-resources. Alliance will continue to update this page with resources.

In the event that COVID -19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.

Joint NC DMHDDSAS and DHB (NC Medicaid) COVID-19 Update for NC Providers

Joint NC DMHDDSAS and DHB (NC Medicaid) COVID-19 Update for NC Providers
Thursday, June 4, 2020
3:00 p.m.

Participant Log-In Information
Please register for COVID-19 Provider Call –  on June 4, 2020 3:00 PM EDT at:  https://attendee.gotowebinar.com/register/7305785682123303948 [attendee.gotowebinar.com]

After registering, you will receive a confirmation email containing information about joining the webinar.

Closed Captioning Services
https://www.captionedtext.com/client/event.aspx?EventID=4446348&Customer… [captionedtext.com]

Please feel free to share with other providers in your network or catchment area

During this call, panelists will present policy updates from DMHDDSAS and DHB representatives followed by an open Q&A session.  In addition to DMHDDSAS and DHB subject matter experts we will also have a representative from DHSR on the call to answer questions you might have.  In consideration of the limited time we have on the call, we ask that you review the guidance link (below) on the DHHS website and FAQs on the NC Medicaid site to see if an answer to your question has already been provided.

As things continue to change and move quickly during the COVID-19 pandemic, please continue to stay abreast of emerging issues, guidance, and policies by visiting:

Broad information and updates: https://www.ncdhhs.gov/divisions/public-health/coronavirus-disease-2019-covid-19-response-north-carolina [ncdhhs.gov]

Policy and Guidance updates:  https://www.ncdhhs.gov/covid-19-guidance [ncdhhs.gov]

COVID19 Executive Orders:  https://www.ncdhhs.gov/divisions/public-health/covid19/executive-orders [ncdhhs.gov]


Please direct any questions or concerns to: [email protected].

Alliance Health highly recommends that you monitor Provider News and our website daily for any updates regarding provider services. Alliance will update this information as we receive any updates from the State in regards to COVID-19.

Please continue to check our COVID-19 resources for providers at alliancehealthplan.org/providers/covid-19-updates-and-resources. Alliance will continue to update this page with resources.

In the event that COVID -19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.

 

Alliance Brand A

Important Information for Residential Providers for Innovations, B3 and TBI Providers

Due to the COVID outbreak, Alliance Health is committed to providing financial support for Innovations, TBI and B3 Residential Services. The rates are specifically to support direct care staff and increased facility related costs due to COVID. These rates are in effect for dates of service June 1-June 30, 2020. Member specific rates will not change.

B3 CodesServiceRate for June
T2033U4Supported Living Level I $                   175.34
T2033HI U4Supported Living Level II $                   211.70
T2033TF U4Supported Living Level III $                   247.45
H2016U4Residential Supports Level 1 $                   113.88
H2016U2 U4Residential Supports Level 1 – AFL $                   108.40
H2016HI U4Residential Supports Level 4 $                   196.12
H2016HI U2 U4Residential Supports Level 4 – AFL $                   199.48
T2014U4Residential Supports Level 2 $                   145.51
T2014U2 U4Residential Supports Level 2 – AFL $                   153.94
T2020U4Residential Supports Level 3 $                   170.82
T2020U2 U4Residential Supports Level 3 – AFL $                   176.72
Innovations
H2016Residential Supports Level 1 $                   113.88
H2016U2Residential Supports Level 1 – AFL $                   108.40
H2016HIResidential Supports Level 4 $                   196.12
H2016HI U2Residential Supports Level 4 – AFL $                   199.48
T2014Residential Supports Level 2 $                   145.51
T2014U2Residential Supports Level 2 – AFL $                   153.94
T2020Residential Supports Level 3 $                   170.82
T2020U2Residential Supports Level 3 – AFL $                   176.72
T2033Supported Living Level 1 $                   175.34
T2033HISupported Living Level 2 $                   211.70
T2033TFSupported Living Level 3 $                   247.45
TBI
H201622Residential Supports 1 $                   138.38
H2016U2 22Residential Supports Level 1 – AFL $                   138.38
T201422Residential Supports 2 $                   180.02
T2014U2 22Residential Supports Level 2 – AFL $                   180.02
T202022Residential Supports 3 $                   257.17
T2020U2 22Residential Supports Level 3 – AFL $                   357.17

Please direct any questions or concerns to: [email protected].

Alliance Health highly recommends that you monitor Provider News and our website daily for any updates regarding provider services. Alliance will update this information as we receive any updates from the State in regards to COVID-19.

Please continue to check our COVID-19 resources for providers at alliancehealthplan.org/providers/covid-19-updates-and-resources. Alliance will continue to update this page with resources.

In the event that COVID -19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.

Alliance Brand A

UPDATE:  Provider Financial Stabilization Program for Child MH/SUD Residential and PRTF Services

UPDATE:  Provider Financial Stabilization Program for Child MH/SUD Residential and PRTF Services.

Due to the COVID outbreak, Alliance Health is committed to providing financial support for our Medicaid funded Child Residential Services. The rates are specifically to support direct care staff and families, increased expenses to meet children’s’ education and nutrition needs during extended school closure and COVID related supplies. Each level of service  has a Scope of Work to clarify those expectations.

Alliance is extending the date of the rate enhancement thru June 30, 2020 for the Child MH/SUD Residential and PRTF services. The table below outlines the rate increase per level of care along with the associated procedure codes.

CODE TABLE
Level of CareProcedure CodeCOVID 90 Day Rate Increase
PRTFRC 91115%(based on provider rate)
Therapeutic Foster Care, IAFT, Enhanced TFC, IDD/MH TFCS5145

S5145 22 HA
S5145 22 Z1
S5145 22 Z2

$109.49

 

$218.28

$131.75

$222.00

 

Level IIH2020$151.57
Level III & IVH0019 HK
H0019 HQ
H0019 TJ
$378.85

$279.46

$227.70

Rapid ResponseS5145 22 Z3$260.00

 

Important Information regarding State Funded Residential providers

Due to the COVID outbreak, Alliance Health is committed to providing financial support for our State Funded Residential Services. The rates are specifically to support direct care staff and increased facility related costs due to COVID. These rates are in effect from June 1-June 30, 2020.

There are some State Funded specialized residential services that are not included in the grid below, but will be notified individually for their program specific enhanced rate. Individual agencies impacted by those exceptions will be notified by their Provider Network Development Specialist.

CODE TABLE
Level of CareProcedure CodeJune Rate

 

Group Living HighYP780$162.74
Group Living ModerateYP770$86.80
Group Living LowYP760$63.58
Family Living LowYP740$57.50
Supervised Living LowYP710$33.26
Supervised Living-2YM812$186.29

 

Update on Telephonic Codes

The below telephonic codes will be extended through the conclusion of the State of Emergency related to COVID-19. Please note, Alliance is currently working through the setup of extending the below COVID-19 related codes and we will issue further guidance thru Provider News on when you can successfully submit billing, please continue to hold billing until this notice is issued.

Procedure CodeDescription
99441 CRPHONE E/M PHYS/QHP 5-10 MI
99442 CRPHONE E/M PHYS/QHP 11-20 MIN
99443 CRPHONE E/M PHYS/QHP 21-30 MIN
98966 CRPHONE E/M NON-PHYS QHP 5-10 MIN
98967 CRPHONE E/M NON-PHYS QHP 11-20 MI
98968 CRPHONE E/M NON-PHYS QHP 21-30 MIN
99446 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 5-10 MIN
99447 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 11-20 MIN
99448 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 21-30 MIN
99449 CRINTERPROFESSIONAL CONSULTATIONS QHP TO MD 31 + MIN

 

Important Information for Innovation, TBI and IDD Providers

The Division of Health Benefits (NC Medicaid) issued Special Bulletins COVID-19 #75 & 76   Behavioral Health Service Flexibilities– Innovations and TBI Waivers’ Appendix K and Developmental Disability State Funded Benefit Plans. Please note, Alliance is currently working through the setup of using COVID-19 related GT and CR modifiers and we will issue further clarification and guidance by the end of next week to identify effective date to submit billing using these modifiers.

https://medicaid.ncdhhs.gov/blog/2020/05/01/special-bulletin-covid-19-75-telehealth-and-virtual-patient-communications-clinical

https://medicaid.ncdhhs.gov/blog/2020/05/01/special-bulletin-covid-19-76-telehealth-and-virtual-patient-communications-clinical

 


Please direct any questions or concerns to: [email protected].

Alliance Health highly recommends that you monitor Provider News and our website daily for any updates regarding provider services. Alliance will update this information as we receive any updates from the State in regards to COVID-19.

Please continue to check our COVID-19 resources for providers at alliancehealthplan.org/providers/covid-19-updates-and-resources. Alliance will continue to update this page with resources.

In the event that COVID -19 seriously impacts your ability to provide services to our members, please notify Alliance immediately by submitting the Temporary Disruption of Service Delivery form found on our website.

 

Community Mental Health Center at Cape Fear Valley Crisis

24/7 Operations Begin at Cumberland Recovery Response Center

Cumberland Recovery Response Center (CRRC) is now operating 24/7 at its facility at 1724 Roxie Avenue in Fayetteville. Formerly known at the Roxie Center, it provides a range of services for people experiencing mental illness and substance use disorder, and is designed to provide a clinically appropriate, community-based option to help stabilize those in behavioral health crisis without a hospital emergency department or inpatient setting. Learn more.

Webinar graphic calendar

Telehealth: What You Need to Know Now and Tomorrow

The i2i Center for Integrative Health is sponsoring a two-part webinar series focusing on telehealth. Part I on June 2 at 10:30am-noon will help providers create processes that will prepare them for future audits and to relay practical information that can help providers support individuals using Telehealth during the crisis. Part 2 on June 16 from 10:30am-noon will provide a thoughtful discussion of the items programs that wish to expand their use of telehealth services following this current crisis need to consider as they continue down the path of telehealth services. There is a fee for the webinars. Register here.

Call Center Representative

Hope4Healers Hotline

Hope4Healers is a partnership between NC DHHS and the North Carolina Psychological Association that offers resources including a hotline staffed 24/7 by licensed therapists for health care workers and their families who need emotional support for being on the COVID-19 front lines. The hotline number is (919) 226-2002. Other resources, including information about how to volunteer to staff the hotline, are available here.

Provider Perspectives on Telemedicine

Join three LME/MCO Chief Medical Officers and members of their provider networks Thursday from 3:00-4:00pm as they discuss the challenges and opportunities of delivering behavioral healthcare through telemedicine. Alliance Health CMO Mehul Mankad, MD will talk with Britni Eaton, MS about Monarch’s experiences with this “new normal” for serving people in need during the COVID-19 pandemic. Register for the live webinar by clicking here.

Guidance For GT/CR Modifiers

On Thursday April 16, 2020, the Division of Health Benefits (NC Medicaid) issued Special Bulletin COVID-19 #46:  Behavioral Health Service Flexibilities.  Alliance has completed adding the codes associated to the flexibilities into Alpha.

GUIDANCE FOR GT/CR Modifiers: Click here for the list of GT and/or CR modifiers that have been added to provider contracts effective March 10, 2020. These codes were added to Medicaid and State contracts for existing providers of these outpatient and enhanced service codes as outlined below.

Providers will be required to utilize the codes/modifiers for any of the service flexibilities that are being provided with service dates starting on and after May 23, 2020.  HOWEVER, the codes are currently active in Alpha and providers can choose to use the codes prior to May 23, 2020, as their billing systems allow.

Important to Note: 

  • Providers that will deliver these services via audio/visual to COVID-19 must add both modifiers (GT and CR) to the code when submitting for reimbursement.
  • If the services are delivered telephonic only, then the provider will only use the CR code.

Providers that have submitted claims prior to this notification will not be required to resubmit claims at this time.  Please use the GT CR and CR modifiers to COVID related service delivery with claims submitted with dates of service no later than May 23, 2020.

List of GR and/or CT modifiers.