JUNE 23, 2022 | COMMUNICATION BULLETIN 2021-22 ISSUE 67 IN THIS ISSUE: Hard Claims Cutoff for Cardinal Innovations Healthcare Network Providers | Provider Touchpoint | Incident Reporting: Tips and Requirements | National Core Indicators™ Staff Stability Survey for 2021 Available
Hard Claims Cutoff for Cardinal Innovations Healthcare Network Providers As a reminder, the hard submission cutoff for all Cardinal Innovations Healthcare claims is Thursday, June 30, 2022. Claims must be submitted through either the Cardinal 837 process or Provider Direct. Please note: Hospitals that have 180 days to bill or any claims based on retroactive Medicaid prior to Jan. 1, 2022, are exempt from this deadline. For assistance, call Vaya’s Claims Help Line at 1-800-893-6246, ext. 2455, or email claims@vayahealth.com.
Provider Touchpoint The next Provider Touchpoint webinar will be 11 a.m.-12 p.m. on Friday, July 15, 2022. Please check next week’s Provider Communication Bulletin for full information and the webinar link.
Incident Reporting: Tips and Requirements Please ensure you are submitting incident reports properly by reviewing the following information and tips from Vaya’s Grievance Resolution & Incident Team. Host and Home LME/MCO clarification: The Host LME/MCO should always be the county where the site where services were delivered is located. The Home LME/MCO should be the county of the individual’s funding eligibility. There may be times when the Host and Home LMEs are different. When this occurs, make sure both appropriate LME/MCOs are indicated (and therefore notified of the incident). For further assistance, refer to the NCDHHS Incident Response and Reporting System Manual . When different LME/MCOs are involved:
Providers must respond to requests from either LME/MCO. The Host LME/MCO is responsible for reviewing, responding to, and following up on incidents that occur within their catchment area and/or with a network provider, even if the individual involved is not a member of that LME/MCO. Disclosing information: Information regarding (but not limited to) diagnosis and treatment services, including substance use information, may be shared among the providers, LME/MCO staff, and NCDHHS staff who are involved in the incident review process. Records including protected health information (PHI) may be shared between providers and LME/MCOs for any member as allowed under the umbrella of health care operations and “covered entities” (HIPAA and 42 CFR Part 2) for the purposes of treatment, payment, or health care operations, without additional consent from the member. Saved vs. submitted reports: When completing an incident report, make sure you submit the report, not just save. LME/MCOs cannot view saved incident reports. To correctly submit a report, click the “Submit Incident Report” button located on the last tab of the Supervisor Actions section. This applies to both new submissions and resubmissions. Even if the report is not submitted, you will receive an incident number. This number is used to access the report at a later time. Do not share the incident number with the LME/MCO or anyone else outside of your provider organization – sharing the number externally is a HIPAA violation. Look for the thumbs-up graphic on the screen to know your report has been submitted successfully. IRIS training: Free incident reporting training is available online through the Learning Lab on Vaya’s Provider Central website. Additionally, you may request a live training if your agency would benefit from a more focused training session. Access the online training at any time: Incident Report Online Training . Request training for your agency by emailing IncidentReport@vayahealth.com.
National Core Indicators™ Staff Stability Survey for 2021 Available The National Core Indicators™ (NCI) Staff Stability Survey for I/DD service providers is available through June 30, 2022. Vaya encourages I/DD network providers to complete the survey and share issues affecting the I/DD direct support worker workforce. Provider agencies should have received an email with the survey with the email subject: "NC NCI Staff Stability Survey 2021”. If you are an I/DD provider and have not received the survey link, or if you have questions, email NCISurvey@dhhs.nc.gov.
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