DECEMBER 16, 2021 | COMMUNICATION BULLETIN 2021-22 ISSUE 33 IN THIS ISSUE: Vaya Health/Cardinal Innovations Consolidation Update | Q&A Webinar for Vaya and Cardinal Innovations Network Providers | Notice of Contract Assignment/Amendment for Cardinal Innovations Providers | Care Manager Assignments for Members Transitioning to Vaya | Provider Communication Bulletin Schedule for December 2021 | Provider Orientation Webinars for Cardinal Innovations Providers – Resource Materials | 2022 Vaya Check Write Schedule Available | AlphaMCS Login Requests | AlphaMCS Portal University | Vaya Incident Reporting for Transitioning Cardinal Innovations Providers | AFL Site Reviews and Credentialing for Transitioning Cardinal Innovations Providers | Coordinated Response to a Sudden Closure of a Child Residential Care Facility | Rate Floor for Crisis Services and COVID-19/PHE Rate Supplements
Vaya Health/Cardinal Innovations Consolidation Update Vaya and Cardinal Innovations continue to work toward a seamless transition for members and providers as we near our consolidation effective date of Jan. 1, 2022. Vaya’s experience managing multiple consolidations with other LME/MCOs over the years has guided our efforts throughout the consolidation process and will continue to do so. Our experience has taught us that we may not be able to predict all challenges or “speed bumps” that may arise as part of this important undertaking. However, we remain committed to our promise to do everything in our power to minimize disruptions and be as prepared as possible to responsibly navigate the weeks ahead. A significant challenge has been the compression of the original consolidation timeline from April 2022 to Jan. 1. Vaya and Cardinal staff are doing all we can, including working seven days a week, to avoid disruptions for members or providers while ensuring a successful consolidation on the condensed schedule. At all times, our goal is to ensure continuity of care and minimize provider burden. As always, we are here for our provider network. If you have any questions regarding consolidation or provider-related issues, please reach out by emailing provider.info@vayahealth.com or calling our Provider Help Line at 1-866-990-9712. Alongside our expanding provider network, we continue moving forward together.
Q&A Webinar for Vaya and Cardinal Innovations Network Providers Tomorrow, Dec. 17, 2021, 11 a.m.-12 p.m. Vaya’s Provider Q&A Webinars are an important source of the most up-to-date information on topics
that affect Vaya and Cardinal Innovations network providers during consolidation. Registration is not required. All network providers are encouraged to attend. Please note: This will be the last Q&A webinar for 2021. Our next webinar is scheduled for Jan. 7, 2022.
Q&A WEBINAR FOR VAYA/CARDINAL NETWORK PROVIDERS – DEC. 17, 2021
Notice of Contract Assignment/Amendment for Cardinal Innovations Providers In November 2021, all providers in good standing with both Vaya and Cardinal that were contracted with Cardinal Innovations received a contract assignment or amendment for review and execution via DocuSign. Approximately 90% of providers have executed these agreements – thank you! Consistent with Vaya’s contract with NC Medicaid, we are required to have a written contract with providers to reimburse for claims (except for emergency and post-stabilization care services, which do not require a contract). Providers who have not signed the contract amendment or assignment prior to Jan. 1, 2022 will not have access to AlphaMCS to submit service authorization requests (SARs) or file claims for services provided beginning Jan. 1, 2022. We strongly encourage each provider currently serving a Cardinal Innovations member to promptly review and execute the contract assignment or amendment issued to you. If you have questions or concerns about your contract assignment or amendment, please email contracts@vayahealth.com and copy provider.info@vayahealth.com. You may also call the Cardinal Innovations Provider Line at 1-855-270-3327or Vaya Provider Help Line at 1-866-990-9712 for assistance. If you, as a provider, do not enter into an executed assignment or amendment with Vaya by Dec. 31, 2022 or have not reached out to Vaya in advance of this date with bona fide questions or concerns about your contract assignment or amendment, we will consider your inaction to mean that you do not want to enter an agreement with Vaya to continue delivering services to the members you currently serve through your Cardinal Innovations contract, and we will begin working with you to appropriately transition members and recipients to new service provider to ensure continuity of care.
Care Manager Assignments for Members Transitioning to Vaya Care management in the nine counties transitioning from Cardinal Innovations to Vaya will change from the current regional model to a county-based model. This change may result in a different care manager assignment for some members. Affected members will receive a “warm hand-off” in which the existing care manager coordinates a discussion with the member and new care manager to discuss the transition and answer questions If there is a change in care manager, the care manager will also notify the member’s care team. If you are unsure if the member(s) you serve will change care managers, you can find out by calling Cardinal Innovations or Vaya. Prior to Dec. 28, 2021, call the Cardinal Innovations Provider Line at 1-855-270-3327. Starting Dec. 28, 2021 call Vaya’s Access to Care Line at 1-800-849-6127.
Provider Communication Bulletin Schedule for December 2021 Due to Vaya’s holiday closure schedule, Provider Communication Bulletins will be distributed the next two Wednesdays, Dec. 22 and 29, 2021. We will return to our normal Thursday schedule on Jan. 6. 2022.
Provider Orientation Webinars for Cardinal Innovations Providers – Resource Materials The webinar recordings and slide decks from the Provider Orientation webinars for Cardinal Innovations providers have been posted to the Learning Lab on Vaya’s Provider Central website.
2022 Vaya Check Write Schedule Available The 2022 Check Write Schedule is now available on the Vaya website. Please note that December 2022 dates are subject to change due to the launch of Behavioral Health I/DD Tailored Plans, currently scheduled for Dec. 1, 2022. Vaya will promptly post an updated schedule if any dates are changed.
AlphaMCS Login Requests To access AlphaMCS as of Jan. 1, 2022, Cardinal network providers that do not already have a Vayaissued AlphaMCS login must submit names of staff who require an AlphaMCS login as soon as possible. Please visit the AlphaMCS page on Vaya’s Provider Central website to complete the AlphaMCS Login Request Form . After you have been set up as a provider in AlphaMCS, Vaya will contact you regarding your login information.
AlphaMCS Portal University All Cardinal Innovations network providers can now access the AlphaMCS Portal University to complete AlphaMCS training. To ensure a smooth transition to Vaya on Jan. 1, 2022, we recommend that all Cardinal Innovations providers complete the AlphaMCS training prior to Dec. 31, 2021.
Vaya Incident Reporting for Transitioning Cardinal Innovations Providers Starting Jan. 1, 2022, Vaya will become responsible for incident reporting for providers in the nine counties transitioning from Cardinal Innovations. Cardinal Innovations network providers should continue to submit reports for October through December 2021 to Cardinal Innovations. Please note that quarterly reports due in January and February 2022 are for October through December 2021 and should continue to be submitted to Cardinal Innovations. When reporting incidents to Vaya, please use the following email contacts: Submit the QM11 report form by the 10th of the month that follows the quarter to incidentreport@vayahealth.com.You can also use this email to get answers to general questions or for other correspondence regarding incident reporting. Submit backup staffing forms by the 10th of the month that follows the quarter to backup.staffing@vayahealth.com. For more information and to obtain reporting forms, visit the Vaya website Incident Reporting page.
AFL Site Reviews and Credentialing for Transitioning Cardinal Innovations Providers
Vaya’s Site Review team is available to assist providers transitioning from Cardinal Innovations with any AFL questions. Vaya’s Site Review Specialists will contact transitioning providers to schedule an annual site review for transitioning homes. To notify Vaya of a new unlicensed AFL or any changes to an existing unlicensed AFL, submit the AFL Update Form , located on the Vaya website Monitoring page. Notification is not necessary for sites and locations that are already credentialed with Cardinal Innovations. For more information, email AFL.Info@vayahealth.com. Site Review Information Vaya conducts annual reviews of unlicensed AFLs to monitor for member safety. Unlicensed AFLs must be reviewed before a member moves into the home and annually thereafter (every two years for State-funded homes). Please note: An HCBS Self-Assessment survey is required for AFLs with members receiving Innovations Waiver services, with submission required prior to placing a member in the home. AFLs billing Long Term Community Support (LTCS) must scan the completed paper copy of the HCBS survey and return it to hcbs@vayahealth.com. Vaya cannot review a home until all HCBS requirements have been met. Upon approval of the HCBS survey, the provider must notify the site review team of any of the following using the AFL Update Form : AFL homes in need of review prior to a member being placed When a member moves out or is no longer receiving AFL services in the home Any other change, including changes in the provider, license, or member If an emergency placement is necessary, and Vaya’s Site Review team cannot be contacted, the provider agency QP may arrange for placement in an AFL home after completing and submitting the HCBS. Following an emergency placement, providers must complete and submit the AFL Update Form the next business day. Vaya will conduct a site review within five business days before the AFL will be considered a permanent placement. Homes must meet all HCBS and NCDHHS requirements outlined in the Unlicensed AFL Monitoring Tool available on the NCDHHS website. Proof of any correction is the responsibility of the agency and should be sent to the Site Review Specialist within 30 calendar days from the initial date of the AFL review. As a reminder, AFL reviews are member-specific. Each member has specific skills and needs. A home approved for one member may not necessarily be approved for another.
Coordinated Response to a Sudden Closure of a Child Residential Care Facility On Dec. 3, 2021, NCDHHS released Joint Communication Bulletin #J405 to communicate that effective Dec. 1, 2021, the Department will implement the Operational Guide for a Coordinated Response to a Sudden Closure of a Child Residential Care Facility. The guide applies to providers of child group homes, psychiatric residential treatment facilities, family care homes, and supervised living facilities for people with mental health disorders and/or I/DD, often called 5600 group homes. Response teams will include representatives from the Division of DMH/DD/SAS (lead agency), DHSR, DHB, the State DSS, the Division of Child and Family Well-Being, LME/MCOs, and Standard Plans with an affected member/resident, as well as county DSS agencies with affected members/residents. The provider agency will continue to be responsible for the health and safety of each resident throughout the transition and closure process. Provider agencies are expected to work closely with LME/MCOs and NCDHHS by assisting with discharge planning, transferring records and personal belongings, and other activities necessary for a coordinated discharge and transition process.
Rate Floor for Crisis Services and COVID-19/PHE Rate Supplements Please review the linked Provider Memo on rate floor increases for crisis services and COVID-19/PHE Rate Supplements.
VAYA HEALTH | vayahealth.com | providers.vayahealth.com