Do I need to enroll Medicaid consumers in the Alpha system?

No. Consumers with Medicaid in Durham, Wake, Cumberland or Johnston counties are automatically enrolled in the Alpha Provider Portal. Providers will still be responsible for confirming Medicaid eligibility prior to providing services. Enrollment status with Alliance does not guarantee or confirm Medicaid eligibility.

How do I update a consumer’s information in the Alpha Provider Portal?

  • Click MENU.
  • Click CLIENT UPDATE.
  • Click CREATE.
  • Click SEARCH next to the patient box.
  • Enter last name and DOB of patient.
  • Click SEARCH.
  • When name comes up, double click on the name. That patient’s information will then populate in the form.
  • Update any information on the first page.
  • Scroll to bottom of page, click SAVE. You will then be asked if you want to GO TO CLINICAL PAGE.  Click GO TO CLINICAL PAGE.
  • Click ADD box next to the field you need to update/add to. Enter the appropriate information. Fields with a red asterisk are required.
  • To enter target pop, diagnosis, medication, start typing a description and choose one of the options provided.
  • Go to bottom of page and click SAVE. This will take you back to page 1.
  • Indicate in the COMMENTS SECTION what was updated/changed.
  • Click SUBMIT.
  • Once this Client Update Request is approved by Alliance the new information should display in the system.

Can you help me locate my consumer in the Alpha Provider Portal?

  • Click MENU, PATIENT, PATIENT SEARCH.
  • Make the PATIENT tile the largest tile.
  • Enter last name and birth date of consumer.
  • Click SEARCH.
  • If the consumer does not appear in the search:
    • Verify the Date of Birth.
    • Verify the spelling of the last name.
    • If the patient has a hyphenated ast name, try the search both with and without the hyphen.
    • If you know the patient’s Social Security Number, remove birth date and enter SS#.
    • If still experiencing problems locating the consumer contact the Alliance Access and Information Center (800) 510-9132 for assistance.

What do I do when I get the error message “Object Reference Not Set to an Instance of an Object” in the Alpha Provider Portal?

The best thing to do in this situation is to log out of the Alpha Provider Portal and log back in.

What is the size limit for documents attached in the Alpha Provider Portal?

The maximum size for each document is 3MB.

How do I create and submit a SAR (Service Authorization Request) in the Alpha Provider Portal?

  • Click MENU, SAR.
  • Make the SAR tile the largest tile.
  • Click CREATE.
  • Logistics
    • On the right hand side of the SAR Entry screen, next to the PATIENT NAME field, click on the SEARCH box.
    • Enter Last Name and Birth Date of patient you wish to create a SAR for and click SEARCH.
    • When the name appears, double click on the patient’s name. The patient’s information will populate in the Patient Fields on the SAR Entry screen.
    • The fields marked by the red asterisks are required fields.
    • If MH services are being requested, include LOCUS/CALOCUS.
    • If SA services are being requested, include an ASAM score.
    • If DD (Developmental Disability) services are being requested, include a SNAP score.
  • Diagnostic Profile
    • To enter a diagnosis start typing either the numerical code or the diagnosis description. When Options appear you must click on one of them.
  • Substance Abuse
    • If a consumer has a Substance Abuse diagnosis or you are requesting Substance Abuse services for a consumer, information related to the Substance Abuse is required.
    • To add Substance Abuse information click on the “+” sign under the Substance Abuse section.
    • Complete the empty fields.
    • Click ADD.
    • Add additional substances used as appropriate.
    • If a line entered needs to be edited, click on the line and click EDIT.
    • If a line entered needs to be removed, click on the line and click on the “-“ sign to remove that line.
  • Medical Use
    • Enter PRIMARY CARE PHYSICIAN name.
    • Indicate if there is a signed release to Primary Physician.
    • Indicate Medically Compliant or Medically Non-Compliant.
    • Add comments as appropriate.
    • Enter medication prescribed to consumer for medical and psychiatric reasons. Multiple medications can be added to this section.
    • Start typing the name of medication and choose from options that appear by clicking on the name of the medication.
    • Type in the dosage of the medication.
    • Type in Medication Regimen (how many times/day).
    • Type in how many months consumer has been prescribed medication.
    • If Dosage, Medication Regimen or # of Month are unknown, type in “Unknown.”
    • Enter “allergies” by typing in the field.
  • Clinical Document
    • Choose Document Type from dropdown.
    • Enter an Effective Date for the document.
    • Enter an End Date for the document.
    • Click UPLOAD FILE.
    • Locate document on your computer.
    • Click on the document.
    • Click OPEN. Document will appear in list.
    • If document is attached in error, click on the “X” in the REMOVE column of the document you wish to remove.
  • Request for Service
    • Choose Benefit Plan from the dropdown.
    • Choose Definition from the dropdown.
    • Choose Service Code from the dropdown.
    • Choose appropriate site from the dropdown. (Note: Authorizations and Claims in the Alpha Provider Portal are SITE SPECIFIC.)
    • Enter an Effective Date for the service you are requesting.
    • Enter an End Date for the service you are requesting.
    • Enter number of UNITS for the service you are requesting.
    • Choose FREQUENCY from the dropdown.
    • Press the TAB key on your keyboard. The system will automatically enter “TOTAL UNITS” based on UNITS and FREQUENCY.
    • Enter clinical information, name, credentials, contact number and date in the JUSTIFICATION FOR SERVICE REQUEST box.
    • To request more than one service on a SAR, click on ADD SERVICE at the bottom of the SAR ENTRY screen and enter the information. Up to 5 difference services can be requested on the same SAR.
    • Click SUBMIT when ready to submit the request for review by the Utilization Management team.

How do I search for a SAR by SAR ID# in the Alpha Provider Portal?

  • Click MENU.
  • Click SAR.
  • Click FILTER.
  • Enter the SAR ID# in the SAR ID box.
  • Click SEARCH.

How do I know the status of a SAR (Service Authorization Request) I have submitted in the Alpha Provider Portal?

  • Click MENU, SAR.
  • Click FILTER.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Click on the SAR# you wish to view.
  • Scroll to the bottom of the screen to the TIMELINE. Here you will see when the SAR was created, submitted and assigned to UM staff for review, etc.

How do I know who is reviewing the SAR I submitted so I know whom to call with questions about the SAR and/or questions about the decision rendered?

  • Click on MENU, SAR.
  • Click FILTER.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Click on the SAR# you wish to view.
  • Scroll to the bottom of the screen to the TIMELINE. In box #3 you will see the name of the UM staff member to whom the SAR has been assigned and the date it was assigned.

How do I find a SAR I have saved, update it and resubmit it?

  • Click MENU, SAR.
  • Click FILTER.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Click the SAR# you wish to update.
  • Click the “3” in the upper right hand corner of the main SAR tile.
  • Click the “-“ next to the “3”.
  • Click UPDATE.
  • Modify information in the SAR.  Please be sure to review all information for accuracy, including the effective and end date requested.
  • Scroll to the bottom of the SAR and click SUBMIT.

How do I provide additional information and documents for a SAR under review?

  • There is no need to submit a new SAR to provide this information.  Additional information requested by UM Care Managers reviewing the SAR can be added to the current SAR under review.
  • To add additional comments to the SAR under review:
    • Click MENU, SAR.
    • Click FILTER.
    • Enter Patient Last Name and Patient First Name.
    • Click SEARCH.
    • Click the SAR# you wish to add comments to.
    • Make the SAR JUSTIFICATION tile the largest tile.
    • Click CREATE.
    • Choose COMMENT TYPE from the dropdown.
    • Enter additional information in the COMMENT box.
    • Click SAVE.
    • When you see the “Inserted Successfully” message, click OK.
  • To add documents to the SAR under review:
    • Click MENU, SAR.
    • Click FILTER.
    • Enter Patient Last Name and Patient First Name.
    • Click SEARCH.
    • Click the SAR# you wish to add comments to.
    • Make the SAR JUSTIFICATION tile the largest tile.
    • Click CREATE.
    • Click UPLOAD next to the Document field.
    • Choose Clinical Doc Type from the dropdown.
    • Click UPLOAD FILE.
    • Locate document on your computer and click on the name of the document.
    • Click OPEN. The name of the document will now appear in the FILE NAME field.
    • Enter an EFFECTIVE DATE for that document.
    • Enter an END DATE for that document.
    • Click SAVE.
    • When you see the “Inserted Successfully” message, click OK.
    • Choose COMMENT TYPE from the dropdown.
    • Enter information in the COMMENT box.
    • Click SAVE.
    • When you see the “Inserted Successfully” message, click OK.

How do I rescind or withdraw a SAR?

  • Click MENU, SAR.
  • Click FILTER.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Click the SAR# you wish to rescind or withdraw.
  • Make the SERVICE tile the largest tile.
  • Click the “3” in the upper right hand corner of the SERVICE tile.
  • Click the RESCIND button of the SAR you wish to withdraw.
  • Enter a “Reason for Rescinding”.
  • Click SAVE.
  • You will see a message “Do you really want to Rescind the SAR?” Click OK or Cancel.
  • You will see a message “SAR Rescinded Successfully.” Click OK.
  • The SAR reverts to SAVED status.
  • Note: A SAR can only be rescinded if Alliance UM staff have not yet taken action on a SAR.

How do I find the reason that my Service Authorization Request was denied?

  • Click MENU, SAR.
  • Click FILTER.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Click the SAR# you wish to view.
  • Make the SERVICE tile the largest tile.
  • Click the “3” in the upper right hand corner of the SERVICE tile.
  • Click VIEW.
  • Scroll to the “Clinical Justification” box. The reason for denial will be here and additional information will be in the “Justification for Service Request” box.

How do I request a Peer-to-Peer conversation after a SAR I submitted was denied or partially denied?

Contact Ashley Lassiter in the Eligibility and Enrollment Department at (919) 651-8523 or Tasha Jennings, Eligibility and Enrollment Department Supervisor, at (919) 651-8527.

What does “Copy SAR” mean in the Alpha Provider Portal?

The Copy SAR function in Alpha allows providers to create a SAR using information already in the system for a specific consumer. Filter for the consumer’s most recent SAR, click COPY SAR, and review the information for accuracy including diagnosis, justification for service, and the effective and end date requested. Attach the required documents to the SAR and submit SAR for review.

How do I print a SAR?

  • Click MENU, SAR.
  • Click FILTER.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Click the SAR# you wish to print.
  • Make the VIEW SAR tile the largest tile.
  • Scroll to the bottom of the page.
  • Click PRINT.
  • Enter a File Name for the SAR you are preparing to print. Note where on your computer this document is being saved so you know where to find the document on your computer.
  • Click SAVE.
  • Locate the document on your computer and print the document as needed.

How do I look up an authorization in the Alpha Provider Portal?

  • Click MENU, AUTHORIZATION.
  • Make the AUTH HEADER BASE tile the largest tile by clicking on the arrow in the box in the upper right hand corner of the tile.
  • Click FILTER.
  • Click PAT SEARCH.
  • Enter Patient Last Name and Patient First Name.
  • Click SEARCH.
  • Double click on the patient you wish to find an authorization for.
  • The Patient ID number will appear in the “Patient ID” box. Click SEARCH.
  • Click the Authorization you wish to view details for.
  • Make the AUTH SERVICES tile the largest tile.
  • Click the “3” in the upper right hand corner of the AUTH SERVICES tile.
  • Use the scroll bar at the bottom of the AUTH SERVICES tile to view additional details, i.e. service, benefit plan, effective date, units authorized, site.

How do I discharge a consumer from services in the Alpha Provider Portal?

  • Go MENU, DISCHARGE.
  • Make the DISCHARGE REQUESTS BASE tile the largest tile by clicking on the arrow in the box in the upper right hand corner of the tile.
  • Click CREATE (filter is to search for discharges you have already created and either had saved or submitted.
  • Click the SEARCH box to the right of the Patient # field.
  • Enter last name and DOB for your consumer you wish to submit a discharge request for.
  • Click SEARCH.
  • When the consumer’s name comes up, double click.  The patient’s name will then populate in the Patient # box.
  • Enter a service code i.e. H2022 (NOT the name of the service) that you are discharging the consumer from (i.e. start typing the code and options will appear).
  • Choose one of the options that appears by clicking on that service code.
  • Enter the required (red asterisk) information that is on the left of the red asterisks.
    • All fields refer to “at time of discharge.” For example, Living Arrangement “at time of discharge.”
    • Try to NOT select “Unknown” or “Other.”
    • # of Arrests in last 30 days – enter a number in this field.
    • SHG stands for “Self Help Groups” – enter a number in this field.
  • If the consumer is being discharged from Substance Abuse treatment complete the information on the right hand side.
  • Enter “Discharge Type” as “Service Only.”
  • Choose a discharge reason from the dropdown box.
  • Enter comments in the COMMENTS box. If you are discharging the consumer from all services at your agency indicate this information in the Comments box. REVIEWER COMMENT box is to be used by Alliance staff.
  • Scroll down to the bottom using the scroll bar on the right hand side.
  • Click SUBMIT. If you wish to save only and not send to Alliance, click SAVE.

Who do I contact if my Provider Information in Alpha needs to be updated?

Who do I contact when I have a question regarding enrollment/eligibility forms and processes?

To follow up regarding enrollment/eligibility forms and processes contact Tasha Jennings, Eligibility and Enrollment Department Supervisor, at (919) 651-8527 or tjennings@AllianceBHC.org.