Provider Touchpoint Friday, August 26, 2022
Vaya Health | Provider Touchpoint How the live broadcast works • You are seeing the broadcast on a 30-second delay. • Your microphone is muted throughout the broadcast. • You may ask questions at any time during the broadcast through the Q&A feature. • Questions can be seen by all attendees after they are published by the moderators. • Questions submitted during the webinar will be addressed at the end of the Vayawebinar.Health|
Vaya Health | Provider Touchpoint How the live broadcast works • If multiple similar questions are received, the Q&A moderators may combine the questions into one before posting. • If you need to ask a question that is specific to your agency or the services you provide, please include your name, agency, and email address with your question. • The Q&A feature will close at 11:50 a.m. to allow us to respond to all questions before the end of the webinar.
Vaya Health | Provider Touchpoint The moderated Q&A is available in the controls bar on your screen. Look for the bubble with the question mark.
Vaya Health | Provider Touchpoint REMINDER PLEASE NOTE: • Some participants have reported problems accessing the webinar Q&A feature while using a non-Microsoft web browser. This is not a Vaya-related issue. Please consider using another browser or the Teams app to join today’s webinar. • If you would like to submit a question and cannot access the Q&A feature, please send your question to provider.training@vayahealth.com. We will add your question to the Q&A for you.
Vaya Health | Provider Touchpoint Where can I find … RecordingsTouchpointProvider and Resources: Provider Central > Learning Lab > Provider Webinars BulletinCommunicationProviderSign-Up: Provider Central > Learning Lab > Sign up for PCB BulletinCommunicationProviderArchive: Provider Central > Learning Lab > BulletinsCommunication
Vaya Health | Provider Touchpoint Antoine Smith, Member and Recipient Services David Boyd, Provider Network Operations Behavioral Health Donald Reuss, Provider Network Operations Behavioral Health (host) George Ingram, Provider Network Operations Physical Health Patty Wilson, VP Learning and Development Vaya subject matter experts
Vaya Health | Provider Touchpoint Heather Sain, Complex Care Management Leah Spare, Complex Care Management Tina Bare, Complex Care Management Christy Pruess, Complex Care Management Justine Tullos, Provider Network Operations (Q&A moderator) Tommy Duncan, Provider Network Operations (co-producer) Lindsay Locklear, Provider Network Operations (producer) Vaya participants
Vaya Health | Provider Touchpoint GUEST PRESENTER President and CEO Benchmarks https://www.benchmarksnc.org/ Karen McLeod
Good morning and welcome
Vaya Health | Provider Touchpoint National Day Women’s Equality Day
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Vaya Health | Provider Touchpoint • Beginning Aug. 15, 2022, the LOCUS© and CALOCUS© (Level of Care Utilization System for adults, children, and adolescents) is no longer required and documentation of the use of these levels of care assessments is no longer necessary when submitting service authorization requests • The documentation requirement will be removed from the authorization guidelines on the Vaya website • If you have questions, email provider.info@vayahealth.com or call the Provider Support Line at 1-866-990-9712 Change in LOCUS© and CALOCUS© Requirement
Vaya Health | Provider Touchpoint • Begins August 17, 2022 • Ends September 16, 2022 • Please submit all suggestions for revisions to: manuals@vayahealth.com Thirty Day Comment Period
Vaya Health | Provider Touchpoint • This Manual is incorporated into your contract with Vaya as a binding requirement. • It is your responsibility to be familiar with, understand, and adhere to all requirements of your contract(s) with Vaya. • Lack of familiarity or understanding is not a valid reason for non-Importancecompliance. of the Provider Operations Manual
Vaya Health | Provider Touchpoint • Provider Support Service Line • Member and Recipient Service Line • Behavioral Health Crisis Line • Nurse Line • Pharmacy Service Line Service Lines
Vaya Health | Provider Touchpoint • Network Provider Coordination Responsibilities • Enrollment, Referral and Assignment for TCM • Outreach, Engagement and Contact Requirements • Care Management for At Risk Children (CMARC) • Care Management for High-Risk Pregnant Women (CMHRP) Tailored Care Management (TCM): Section 9
Vaya Health | Provider Touchpoint • Aligned with NC DHHS public health goals and Quality Strategy • Promoting•Wellness and prevention • Member education and referral programs • Child health and wellness • Women’s health • Tobacco cessation • Opioid misuse prevention • Improving chronic condition management Prevention and Population Health Programs: Section 10
Summary of Medicaid and NC Health Choice Covered Services & Clinical CoverageAPPENDIXPolicies A
Vaya Health | Provider Touchpoint • Primary Care Providers • Network Adequacy and Accessibility Standards • Time and distance standards by provider type • Centralized Provider Enrollment and Credentialing • Tailored Plan Eligibility Criteria New Topics Throughout
Vaya Health | Provider Touchpoint • Copays for physical health and NC Health Choice • Non-Emergency Medical Transportation (NEMT) • Pharmacy Benefit • Durable Medical Equipment New Topics Throughout
Vaya Health | Provider Touchpoint 30-day comment period - Begins August 17, 2022 - Ends September 16, 2022 Please submit all suggestions for revisions to: manuals@vayahealth.com Revisions or Suggestions?
Vaya Health | Provider Touchpoint • Vaya Health’s online Provider Directory is now being sourced from the Provider Enrollment File (PEF). This file is sent daily by the DHHS to the MCO/LME’s. The file contains provider information as registered and approved through the NCTracks enrollment process. • If you find that there is a discrepancy in the way your information currently is displayed, you will need to contact NCTracks directly to get it updated. Once corrected, data will be reflected in the next PEF passed to Vaya. Find a Provider | Vaya Health Vaya’s Online Provider Directory
Member Choice Period
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Vaya Health | Provider Touchpoint • TP mailing of contract stats as of August 25, 2022 : o Total number of TP contracts mailed=1,610 (100%) o Total number of TP contracts counter-executed= 1,250 (77.64%) BH = 920 PH = 328 Hospital = 2 o Total number of contracts unsigned = 360 (22.36%) Tailored Plan Contracting
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Vaya Health | Provider Touchpoint Permanent Supportive Housing Training September 20th, 21st, 27th and 28th from 9 am -1:30 pm • This online training will support CST and ACTT providers by improving their understanding and practice of the Permanent Supportive Housing model. Full attendance and active participation is required for all 4 days (September 20, 21, 27 & 28) to receive the 16-hour credit. • This training is available to CST and ACTT providers within the Vaya, Alliance, and Partners LME/MCO catchment areas. Space is limited. Register for this training at : Permanent Supportive Housing | Vaya Health
Q&A SESSION Questions? Thoughts? Ideas?
Our next TouchpointProviderFriday,Sep.9,2022 11 a.m. – 12 p.m.
