Taxonomy Edits

Alliance will require correct taxonomy on every billing and rendering NPI number beginning July 1, 2017. Please take advantage of the technical assistance the Claims Department is providing over the next five weeks. This will better prepare provider staff for upcoming denials and payments. On August 1, 2017, Alliance will be editing against taxonomy in the Alpha claims system. If your claim submitted into the ALPHA system does not have the same billing and rendering taxonomy as in the ALPHA contract, it will deny. Please contact your Claim Specialist or Claim Analyst with specific questions or contact the Provider Helpdesk at (919) 651-8500, option 1.

Attention LIPs, Agencies and Groups Providing Outpatient and Psychiatric Services-DEADLINE EXTENDED TO JULY 13

To help Alliance enhance its online Provider Search tool it is critical that we collect important information from Licensed Clinicians credentialed by Alliance. All contracted provider entities should follow instructions outlined in the Clinician Maintenance User Guide to access an online portal to provide this information about each of your clinicians. This information includes clinician specialties, languages spoken, and sites at which the clinician provides services. Please help us provide more comprehensive and useful information to people in our communities who use the Provider Search when seeking services. DEADLINE FOR SUBMITTING THIS INFORMATION IS JULY 13.

Important Information About NPI Numbers

The following information may affect provider’s ability to be paid if applicable. Due to upcoming requirements from the State in regards to encounter data, Alliance needs to make changes to ensure that all NPI numbers are active and correctly enrolled in NCTracks. Providers need to ensure their enrollment for each NPI number is active in NCTracks and under the Medicaid Benefit plan in NCTracks. This is required to continue to receive payment from Alliance for dates of service after June 1, 2017 associated with the affected NPI numbers. If an NPI number is terminated in NCTracks and/or terminated in the Medicaid Benefit plan in NCTracks, the NPI numbers will be de-activated in Alpha, resulting in claim denials for dates of service beginning June 1. Providers are responsible for verifying this information in NCTracks and addressing any NCTracks termination issues thru the NCTracks Manage Change Request process. Alliance strongly encourages providers to log into their NCTracks account to verify that their Billing and Rendering NPIs are active as indicated above. Providers are responsible for notifying Alliance at Enrollment@AllianceBHC.org once the NPI number is active in the NCTracks system so the affected NPI number can be re-activated in Alpha. Please ensure that the effective date of your NCTracks request runs consecutively with the end date so there is no lapse in coverage dates or there is risk of recoupment for that time period. Questions can be directed to Enrollment@AllianceBHC.org.

Provider Technical Assistance on Taxonomy Set Up

Alliance is in the process of meeting upcoming contractual requirements. One of these requirements is to ensure providers are submitting correct taxonomies during the claim submission. The taxonomy edit is not activated but will be in the near future. Currently providers have not experienced taxonomy payment denials due to taxonomy-related issues. However, Alliance is anticipating that approximately 50% of our providers may experience non-payment if this is not addressed once the edit is turned on. In preparation for this Alliance is providing one-on-one technical assistance/training to assist providers in identifying taxonomy issues that will lead to payment denials for your agency. We strongly encourage providers to sign up for the technical assistance to help reduce future payment denials and ask that provider staff that are familiar with the claims process attend these trainings. Please bring laptop and any Alpha log in information to be best prepared for the assistance. If you have further questions please contact your assigned Claims Specialist.

The meetings will take place at the Alliance Home Office, 4600 Emperor Boulevard in Durham, according to the following schedule. Register here. Once you are on the calendar click on the training you want to register for – enter 1 in the gray box under RSVP and click on the Confirm RSVP box to complete your registration

June 22, 10am-Noon, Room 237
June 26, 2-4pm, Room 204
June 28, 10am-Noon, Room 204
July 5, 10am-Noon, Room 204
July 12, 10am-Noon, Room 204
July 14, 1-3pm, Room 204
July 19, 10am-Noon, Room 204
July 26, 10am-Noon, Room 204

NCTracks and Manage Change Requests submissions

In order to continue to help support the Provider Network with the Manage Change Requests that Providers submit to NCTracks, Alliance can submit to DMA/DMH a log of MCR’s that are over 3 weeks old to help address the timeliness of the requests.   Alliance asks that Providers send in the spreadsheets no more than once per week following the directions below.  Alliance will send in a compiled log weekly to DMA/DMH.

Guideline for submitting Managed Change Requests for Routing to DMA/DMH:

  1. Providers must submit a Managed Change Request to NCTracks;
  2. The request has to be outside of the three-week standard (at a minimum) that is outlined in the initial provider services correspondence to the provider from NCTracks; and

If the above information is met, then the provider should submit the details on this spreadsheet.   ALL Fields must be completed or we cannot submit.  Please email to enrollment@alliancebhc.org.

Important Information About NPI Numbers

The following information may affect provider’s ability to be paid if applicable. Due to upcoming requirements from the State in regards to encounter data, Alliance needs to make changes to ensure that all NPI numbers are active and correctly enrolled in NCTracks. Providers need to ensure their enrollment for each NPI number is active in NCTracks and under the Medicaid Benefit plan in NCTracks. This is required to continue to receive payment from Alliance for dates of service after June 1, 2017 associated with the affected NPI numbers. If an NPI number is terminated in NCTracks and/or terminated in the Medicaid Benefit plan in NCTracks, the NPI numbers will be de-activated in Alpha, resulting in claim denials for dates of service beginning June 1. Providers are responsible for verifying this information in NCTracks and addressing any NCTracks termination issues thru the NCTracks Manage Change Request process. Alliance strongly encourages providers to log into their NCTracks account to verify that their Billing and Rendering NPIs are active as indicated above. Providers are responsible for notifying Alliance at Enrollment@AllianceBHC.org once the NPI number is active in the NCTracks system so the affected NPI number can be re-activated in Alpha. Please ensure that the effective date of your NCTracks request runs consecutively with the end date so there is no lapse in coverage dates or there is risk of recoupment for that time period. Questions can be directed to Enrollment@AllianceBHC.org.

Attention LIPs, Agencies and Groups Providing Outpatient and Psychiatric Services

To help Alliance enhance its online Provider Search tool it is critical that we collect important information from Licensed Clinicians credentialed by Alliance. All contracted provider entities should follow instructions outlined in the Clinician Maintenance User Guide to access an online portal to provide this information about each of your clinicians. This information includes clinician specialties, languages spoken, and sites at which the clinician provides services. Please help us provide more comprehensive and useful information to people in our communities who use the Provider Search when seeking services. DEADLINE FOR SUBMITTING THIS INFORMATION IS JUNE 21.

Important Information About NPI Numbers

The following information may affect provider’s ability to be paid if applicable. Due to upcoming requirements from the State in regards to encounter data, Alliance needs to make changes to ensure that all NPI numbers are active and correctly enrolled in NCTracks. Providers need to ensure their enrollment for each NPI number is active in NCTracks and under the Medicaid Benefit plan in NCTracks. This is required to continue to receive payment from Alliance for dates of service after June 1, 2017 associated with the affected NPI numbers. If an NPI number is terminated in NCTracks and/or terminated in the Medicaid Benefit plan in NCTracks, the NPI numbers will be de-activated in Alpha, resulting in claim denials for dates of service beginning June 1. Providers are responsible for verifying this information in NCTracks and addressing any NCTracks termination issues thru the NCTracks Manage Change Request process. Alliance strongly encourages providers to log into their NCTracks account to verify that their Billing and Rendering NPIs are active as indicated above. Providers are responsible for notifying Alliance at Enrollment@AllianceBHC.org once the NPI number is active in the NCTracks system so the affected NPI number can be re-activated in Alpha. Please ensure that the effective date of your NCTracks request runs consecutively with the end date so there is no lapse in coverage dates or there is risk of recoupment for that time period. Questions can be directed to Enrollment@AllianceBHC.org.