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DHHS will hold a stakeholder webinar to provide the specifics of Tailored Plan eligibility criteria, enrollment processes, and transitions between Standard Plans and Tailored Plans on March 26 from 1:30 – 2:30 p.m.

On March 18, 2019 DHHS released a final policy guidance paper on these key concepts, which can be found at https://link.zixcentral.com/u/0f8685ee/LClLnDdL6RGGIGPHhnsoMg?u=https%3A%2F%2Ffiles.nc.gov%2Fncdhhs%2FBH-IDD-TP-FinalPolicyGuidance-Final-20190318.pdf.

To Register for the stakeholder webinar:
https://link.zixcentral.com/u/8e76c517/DoNLnDdL6RGGIGPHhnsoMg?u=https%3A%2F%2Fmanatt.webex.com%2Fmanatt%2Fonstage%2Fg.php%3FMTID%3Dee52b3a507e3ebcded6e7cc6019bf92cd

  • Registration is required to access the webinar
  • Audio for this webinar uses computer or cell phone speakers with landline availability

Additional information may be found on the NC Medicaid transformation website at www.ncdhhs.gov/nc-medicaid-transformation.

Next All-Provider Meeting

The next All-Provider Meeting will be held on Wednesday, March 20 at 1:00pm in the Dogwood and Magnolia rooms at the new Alliance home office, located at 5200 W. Paramount Parkway in Perimeter Park in Morrisville. Get directions or access the agenda.

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CSRS Webinar

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.

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Changes to Out-of-State Travel Notification

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.

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Important Update in Psychological Testing Codes

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.​

RFP for Critical Time Intervention

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.

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Updated Provider Application Request Form

Alliance has updated the Provider Application Request form. Please use this form for all requests.

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IRIS Website will be Unavailable on Tuesday, February 19, from 7 to 9 am

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.

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Expedited authorization review process initiated

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.