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Provider Updates
These updates support providers by highlighting new classes, trainings, resources, chats, procedures, and programs. You will also find advice and guidance for providers. Subscribe to updates or See Alliance News
12/01/2021
New Medicaid and Non-Medicaid Benefit Plans Posted
Alliance has posted revised Medicaid and Non-Medicaid Benefit Plans effective December 1, 2021. Benefit plans have been modified as part of the Mecklenburg and Orange County expansion. Providers are encouraged to review both the Medicaid and Non-Medicaid Benefit Plan for the services they provide for information on service coverage, code, authorization submission requirements, authorization guidelines, COVID-19 flexibilities, policy and level of care reference. Benefit Plans are located on our website under Benefits and Services.
Alliance would like to remind providers that when using COVID-19 flexibilities delineated in Special Bulletin #46 and Appendix K that allow services that otherwise require authorization, it is expected that the flexibility and the justifications are reflected in the clinical record. Failure to document support for the use of these flexibilities in the clinical record may result in recoveries by Alliance for affected claims.
As a reminder, Alliance announced a new provider retrospective flexibility extended to new network providers during the month of December.
