MARCH 23, 2023 | COMMUNICATION BULLETIN 2022-23 ISSUE 46 IN THIS ISSUE: Provider Touchpoint | Upcoming Changes to Service Codes and Modifiers | AlphaMCS Sunset Date and Upcoming Provider Portal Trainings | Reminder: 1915(i) Waiver Member Assessments | Attention Therapeutic Foster Care Providers: Revenue Code Change | R.J. Blackley ADATC Closure | Provider Opportunity: Clinically Managed Residential Services | Update to StateFunded Transition Management Services COVID-19 Service Definition
ALL NETWORK PROVIDERS Provider Touchpoint March 31, 2023, 11 a.m.-12 p.m. The Provider Touchpoint webinar is your source for the latest information on topics that affect Vaya Health network providers. We encourage all network providers to attend. Registration is not required. The link to each webinar is published both the week prior to and the week of the event in the Provider Communication Bulletin.
PROVIDER TOUCHPOINT – MARCH 31, 2023
Upcoming Changes to Service Codes and Modifiers Vaya Health is launching our new Provider Portal for claims submission on April 1, 2023. This means that specific service codes plus modifiers will change effective April 1, 2023. The changes affect all claims submitted on or after this date, regardless of the date of service. Please update your billing software to accommodate these changes. Vaya will automatically update any codes plus modifiers listed in your provider contract. For more information, review the memo linked below. Memo: Service Code Plus Modifier Changes Effective April 1, 2023 (March 23, 2023)
AlphaMCS Sunset Date and Upcoming Provider Portal Trainings
Beginning April 1, 2023, all member updates, recipient enrollment, authorization, and claims activities will move from AlphaMCS to Vaya’s Provider Portal . The last day providers will be able to log in to AlphaMCS is March 31, 2023. Vaya will offer multiple trainings to help providers navigate the new portal. Registration is not required. Provider Portal job aids also are available on the Resources page of the Provider Central website. UPCOMING TRAININGS: Provider Portal: Submitting Claims, March 29, 2023, 12:30 p.m.-2:30 p.m. Join online. Provider Portal: Submitting Claims, April 6, 2023, 1-3:30 p.m. Join online. Provider Portal: Enrollment, Authorizations, Documents, and Resources , April 5, 2023, 1:30-4 p.m. Join online.
BEHAVIORAL HEALTH, I/DD, AND TBI PROVIDERS Reminder: 1915(i) Waiver Member Assessments Provider-based Tailored Care Management (TCM) agencies should continue outreach to members currently receiving 1915(b)(3) services in preparation of North Carolina’s expected transition to the 1915(i) Home and Community-Based Services Waiver. TCM providers must complete independent assessments for these members to access to 1915(i) services through the Tailored Plan, scheduled to launch on Oct. 1, 2023. Vaya requests that providers submit the completed assessments and eligibility spreadsheets to 1915i@vayahealth.com by 5 p.m. on the 17th day of each month to ensure we can meet NCDHHS deadlines. If you have questions, email Jennifer Jennings, Substance Use Network Development Director, at jennifer.jennings@vayahealth.com.
Attention Therapeutic Foster Care Providers: Revenue Code Change Beginning April 1, 2023, Therapeutic Foster Care (TFC) providers who have historically billed revenue code 0183 for Therapeutic Leave will no longer be able to bill it as a professional claim in the Vaya Provider Portal . Please ensure that claims for Therapeutic Leave submitted on or after this date are on an institutional claim, regardless of the date of service. For more information, please email claims@vayahealth.com.
R.J. Blackley ADATC Closure In December 2022, NCDHHS announced a partnership to repurpose the R.J. Blackley Alcohol and Drug Abuse Treatment Center (ADATC) in Butner (Granville County) into a 54-bed inpatient psychiatric hospital for children and adolescents operated by UNC Health. The ADATC ceased admissions Feb. 13, 2023, and has subsequently discharged all patients. The counties formerly served by the R.J. Blackley ADATC have been reallocated as follows: Julian F. Keith ADATC (Black Mountain): Anson, Davie, Forsyth, Guilford, Montgomery, Randolph, and Stokes. Walter B. Jones ADATC (Greenville): Alamance, Caswell, Chatham, Durham, Franklin, Granville, Halifax, Harnett, Hoke, Lee, Moore, Orange, Person, Richmond, Rockingham, Vance, Wake, and Warren. As part of outpatient peer support services, both facilities offer transportation and a warm handoff
from referral to treatment to post-discharge community services. For more information, email provider.info@vayahealth.com.
Provider Opportunity: Clinically Managed Residential Services NC Medicaid is developing new services slated to launch later this year as part of the 1115 Demonstration Waiver. These include Clinically Managed Residential Services, which will serve beneficiaries who have a substance use disorder, meet ASAM Level 3.5 criteria, and need a 24-hour structured safe and stable living environment to develop recovery skills. This service will be available to adults and adolescents. For more information, review the draft Clinical Coverage Policy. If your organization is interested in potentially offering this service, email Jennifer Jennings, Substance Use Network Development Director, at jennifer.jennings@vayahealth.com.
Update to State-Funded Transition Management Services COVID-19 Service Definition NCDHHS has rescinded a previous version of NCDHHS LME/MCO Joint Communication Bulletin #J447 and replaced it with an updated version to clarify that the bulletin refers to the Transition Management Services (TMS) COVID-19 Service Definition. Read more: NCDHHS LME/MCO Joint Communication Bulletin #J447 (March 20, 2023) For more information, contact Robin Soderena at 910-612-8317 or Robin.soderena@dhhs.nc.gov or Margaret Herring at 984-236-5057 or Margaret.herring@dhhs.nc.gov.
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