Effective January 1, 2019, the American Psychological Association (APA) has released updated CPT codes for Developmental, Psychological and Neurological testing. Learn more.
A revised FAQ regarding the Referral Screening Verification Process (RSVP) has been added to the Transitions to Community Living page. You can view the updated FAQ document here.
Alliance is excited to present the new and improved Provider Maintenance Application. The Provider Maintenance Application will serve as a way for providers to maintain and update information on their credentialed sites, specialties and ability to accept referrals. This is only phase one of the portal and as Alliance continues to develop and grow the information contained within the portal, this application will provide information into Alliance’s Provider Directory for members, stakeholders, and providers to use when helping Alliance members research treatment options and access treatment.
Providers who have not already created a profile should do so, and include information outlining their ability to accept referrals by funding source, for each identified site, service and specialty. Providers will be able to update their ability accept referrals for these categories, in real time, by updating their profiles in the application.
To access the application, providers may log in at: https://portal.alliancebhc.org/Login/. Providers will see in the upper right corner area a User Guide which may also be accessed via this link: https://portal.alliancebhc.org/Documents/Provider%20PORTAL%20User%20Guide_V1.0.pdf.
Through participation in the Provider Maintenance Application, providers will be able to keep Alliance informed of their ability to accept referrals for specific services, or at specific locations. Providers with updated profiles will be eligible to receive referrals directly from Alliance departments including Access and Care Coordination. Information collected through the portal will also be used to inform network adequacy and capacity. Questions about the Provider Maintenance Referral Application can be directed to Alliance’s Provider Helpdesk ([email protected]) or to Provider Network Development Specialist Melissa Payne at [email protected] or 919-651-8801.
This portal is also used for reporting provider accreditation status. All accredited (CARF, CQI, The Joint, COA) are required to inform Alliance of their accreditation status. If you have any questions regarding the use of the portal please contact Melissa Shaffer at (919) 812-9906 or email [email protected].
Providers are expected to enroll in the system, and review the information contained within their profile no later than January 31, 2019. All providers enrolled in the system are strongly encouraged to also review and update their profiles, especially their ability to accept referrals, on a routine basis, and at minimum every 90 days.
Alliance will create and post a webinar training to the Alliance website for providers during the first quarter of 2019. When it is completed providers will be informed of where to find it on the Alliance website.
(Durham, NC) – Alliance Behavioral Healthcare, the public behavioral health managed care organization, or MCO, for Durham, Wake, Cumberland and Johnston counties, is changing its name to Alliance Health. The new name will be incorporated gradually into Alliance’s informational materials and media over the next few weeks.
“Alliance Health better reflects our future in North Carolina’s public healthcare landscape,” said Alliance CEO Rob Robinson. “It speaks to the integrated whole-person care – physical, behavioral and pharmacy – that we will be providing for the individuals we serve.”
As part of Medicaid transformation, over the next few years North Carolina will create two new kinds of health plans that will serve most Medicaid and NC Health Choice beneficiaries, including individuals currently served by our state’s LME/MCOs. These plans will be referred to as Standard Plans and Tailored Plans.
Standard Plans will provide physical and behavioral healthcare, along with pharmacy services, to people with lower-intensity behavioral health needs. The current timeline calls for Standard Plans to take effect in late 2019 through early 2020.
Tailored Plans will serve people with more severe mental illnesses, substance use disorders, and long-term needs including intellectual/developmental disabilities and traumatic brain injury. The Tailored Plans will provide integrated physical health, behavioral health, and pharmacy services to their members. Alliance Health anticipates being chosen to operate a Tailored Plan. The current timeline calls for Tailored Plans to take effect in mid-2021.
According to Robinson, there will be no changes in the Alliance provider network associated with the name change, and people’s contacts at Alliance are not changing. “It’s important that our members and other stakeholders understand that for now, all that is changing is our name. We just don’t want folks to be confused if they see or hear both names for a little while.”
Individuals will receive full information about future changes regarding their health plan well in advance of those changes. More information about Medicaid transformation is available on the NC Department of Health and Human Services website at www.ncdhhs.gov/assistance/medicaid-transformation.
About Alliance Health
Alliance is a public behavioral health managed care organization, or MCO, with responsibility for the authorization of services for over 439,000 Medicaid-eligible and uninsured individuals and a population of 1.8 million in Durham, Wake, Cumberland and Johnston Counties. It partners with a network of over 2,000 private providers.
Providers who have questions about RSVP and the status of referrals submitted in RSVP should call 984-465-8010 to get their inquiry routed to someone who can help them quickly.
TBI Waiver service needs: Specialized Consultative Services
Who can provide per the waiver:
- Provider agency: national accreditation required.
- Individual independent practitioners: licensure specific to discipline, if applicable.
Specialized consultation services provide expertise, training and technical assistance in a specialty area:
Specialty Areas: Neuro/psychology, behavior intervention, speech therapy, therapeutic recreation, augmentative communication, assistive technology equipment, occupational therapy, physical therapy, nutrition, and other licensed professionals who possess experience with individuals with traumatic brain injury.
Service goal: to assist family members, support staff and other natural supports in assisting individuals with traumatic brain injury.
- A minimum of 500 hours supporting individuals with TBI
- Staff must hold appropriate NC license for physical therapy, occupational therapy, speech therapy, psychology, behavioral analysis (licensure subject to psychology board implementation date) and nutrition; state certification for recreational therapy; board certified behavior analyst-MA; master’s degree and expertise in augmentative communication; state certification in assistive technology.
- Qualified in the customized need of the beneficiaries as described in the Individual Support Plan.
- Must be enrolled in NCTracks.
Interested providers please submit the TBI Waiver – Allied Health and Specialized Consultative Services Provider Application Request, agency summary or CV that demonstrates the minimum of 500 hours supporting individuals with TBI, copy of appropriate license (as applicable), and copy of national accreditation (as applicable).
Attention providers that bill for physician assistants for behavioral health services under NC DMA-Clinical Coverage Policy 8C Subsection 6.1:
Effective November 15, 2018, physician assistants are no longer able to bill “incident to” a physician and would have to be directly enrolled in NCTracks and Alliance in order to provide behavioral health services under this policy.
Alliance is in the process of making a phased move to a new home office located at 5200 West Paramount Parkway, Suite 200, in Perimeter Park in Morrisville. Over the coming weeks staff at the current home office at 4600 Emperor Boulevard will be moving, while staff at the Durham community office will be moving in late January, and staff at the Wake community office later in the first half of 2019. If you have a meeting scheduled at one of our offices over the coming weeks, you are advised to check with the Alliance staff you are meeting with to confirm their location.
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CMS has approved North Carolina’s State Plan Amendment (SPA) for Research Based Behavioral Health Treatments for Autism Spectrum Disorder. The approved SPA will serve as the definition until the new policy has been finalized. This approved SPA is effective immediately. LME MCO’s are required to use this definition for the purposes of authorization, monitoring and reimbursement. Alliance has updated the Medicaid Child Benefit Plan accordingly to reflect what is included in the SPA. Alliance will be offering an information session to review the SPA in the upcoming weeks-please continue to monitor Provider News for the date/time. We encourage all ABA providers to review the SPA to ensure compliance with requirements.
Access and Information Center:
We want to make it easy for you to get the services or information you need. You can call the Alliance Access and Information Center toll-free 24 hours a day.
Representatives are available 8:30am-5:15pm Monday-Friday to answer provider questions about authorization, billing, claims, enrollment and credentialing, the Alpha Provider Portal or other issues.
Confidential Fraud and Abuse Line:
You are encouraged to report matters involving Medicaid fraud and abuse. If you want to report fraud or abuse, you can remain anonymous. Learn more.
Alliance maintains community offices in Durham, Wake, Cumberland and Johnston counties. Addresses and directions to the Alliance offices.