THERAPEUTIC FOSTER CARE NC HEALTH CHOICE AUTHORIZATION DATA ENTRY
Description:
MHP requires Therapeutic Foster Care Providers to key admission/authorization information into our CMHC/MCO system. This process was implemented in response to Value Options no longer mailing hard copies of the certification letters to the LME for those three aforementioned services. In addition, Therapeutic Foster Care Providers providing services to consumers with NC Health Choice will need to enter the skeleton authorization into the CMHC/MCO System and MHP will approve it when it is posted on Value Op... (View this full update)
MHP is allowing the entry of concurrent target populations in the CMHC computer system effective immediately. The system will automatically check for concurrency issues and notify the provider if the selected target population is not valid as a concurrent entry.
To add an additional target population to a client, select the menu option, “Add Concurrent Target Pop” from the Medical Records menu in CMHC. Enter the client ID and press the next button. The first screen to appear will be a listing ... (View this full update)
MHP just completed its Annual Conformance to Quality Report for CARF. Due to 2011 CARF accreditation changes in regards to unauthorized use and possession of weapons MHP has made edits to its current Provider Network Required Policies and Procedures as well as the Provider Monitoring and Oversight Policies and Procedures Checklists. Both documents are attached and changes highlighted. It is the responsibility of ALL providers to ensure that their current policies reflect this change. Thanks for your... (View this full update)
In a review of authorization requests and documentation submitted for the Developmental Therapies service, MHP has identified a number of concerns regarding provider compliance with the service definition. In an effort to assist providers in correctly documenting the Developmental Therapy Service with consumers, MHP has scheduled a mandatory training for Developmental Therapy providers on October 28, 2011 from 9:30am to 4:30pm. The link to register is as follows: http://reg.abcsignup.com/reg/event_page.... (View this full update)
BENEFIT PLAN ADJUSTMENTS FOR COMMUNITY SUPPORT TEAM
Description:
In a review of MHP’s State Benefit Plan to ensure alignment with the Community Support Team Service definition, the following changes will be effective November 1, 2011. The following changes have been made to the Community Support Team service in the Adult Mental Health State Funded Benefit Plan and the Adult Substance Abuse State Funded Benefit Plan available on the MHP website. Service Array Community Support Team
MHP is asking that providers fax to the following number for all authorization requests documentation submission: 828-615-1241. In addition, please attend to the authorization submission requirements as referenced in the following link:
MHP wanted to take this opportunity to provide clarification regarding retro authorization requests. All authorization requests should be submitted prior to the delivery of the service. It is important that providers attend to the timeframes required and documentation required for authorization submission. UM is experiencing a high volume of authorization requests and are processing clean and properly submitted authorization requests as first priority. Providers are required to submit the appropriate do... (View this full update)
Currently providers are required to submit an on-line verification of staff that are still approved to have access to CMHC/Citrix on a monthly basis. Effective June 1, 2011, providers will no longer have to complete this monthly form. The IT Department will be generating a report every month that looks at the last date a staff signs onto CMHC. If a staff person has not used their CMHC ID in last 45 days, the IT Department will inactivate their ID. After a period of 90 days of no activity, the IT Departm... (View this full update)
AUTHORIZATION REQUEST FOR STATE DOLLAR SERVICES THROUGH UM
Description:
MHP’s Utilization Management is experiencing a high volume of authorization requests which is typical for this time in the fiscal year. Typically, the UM department adheres to the 7 day time frame for processing authorization requests, which is a higher standard than is what is required. Due to the volume of the requests, MHP is extending the timeframe for clean and properly submitted authorization requests to 14 days for authorizations with June dates of service.
Please find the procedure for the submission of CAP-MR/DD Invoices below.
1. It is the responsibility of the Targeted Case Managers to track the cost of all home modifications, vehicle adaptations, and transportation charges authorized, billed and paid for during the plan and waiver years and ensure that costs are within limits set by service definitions.
2. All home modifications, vehicle adaptations, and transportation charges must be documented on the Person Centered Plan (PCP) that i... (View this full update)
In order to process claims quickly and transition into the next fiscal year, please refer to the table below for upcoming deadlines.
Monday, June 6, 2011 • Must submit all billing for State Funded Services with dates of service from April 8, 2011 to May 31, 2011. • Must submit all billing for Medicaid Funded Services with dates of service from June 8, 2010 to June 3, 2011. (Refer to Memo dated February 14, 2011 addressing Cutoff Dates for FY 2010-2011)
MHP’s Utilization Management (UM) Department currently reviews service notes documentation on the following service definitions:
1. Personal Assistance 2. Community Support Team 3. Assertive Community Treatment Team 4. Developmental Therapy 5. Substance Abuse Intensive Outpatient Program
MHP’s UM Department will discontinue the review of Personal Assistance and Community Support Team and in turn request service notes documentation on Psychosocial Rehabilitation Services an... (View this full update)
