State-Covered Services for Medicaid Beneficiaries

A provider publication issued on August 1, 2017 detailed services that could NOT be covered should a consumer have a certain type of Medicaid coverage. Alliance is opening State services back up for one of the populations. The original memo stated that consumers with MAFDN, Medicaid Family Planning, and MQBBN/MQBEN/MQBQN, Qualified Medicare Beneficiary, in which Medicaid only pays for the Part B premium only, would NOT be covered by State services. Effective immediately, State services will be covered for individuals with MAFDN Medicaid coverage. This is in effect from October 17, 2017 forward. Retro-authorizations will not be granted. MQBBN/MQBEN/MQBQN, Qualified Medicare Beneficiary, in which Medicaid only pays for the Part B premium only, is still NOT eligible for State funds.

AlphaMCS Build 2.04 Delayed

The AlphaMCS build has been postponed. It is schedule to occur on October 11, 2017.

ALPHA MCS / Mediware Changes

The Mediware/ALPHA provider portal is moving to Version 2.04 to better meet the business needs of Providers and Managed Care Organizations.   Mediware/ALPHA will be updating the CLAIMS module effective October 4th, 2017.  The system will have a new and improved appearance and many users will find the system more user-friendly.   The step-by-step instructions for how to use the new module can be found in the University located on the home page of Alpha provider portal.

ALPHAMCS Claims support is available through the Alliance Provider claims phone queue by calling:  919-651-8500 and pressing *1,  Monday – Friday, 8:30-5:15.  We are also available every Tuesday from 9:30-11:30am for individual 1:1 support at the Home Office located at 4600 Emperor Blvd, Durham.

Alternatives to Guardianship Info Session

Providers are invited to an Alternatives to Guardianship Information Session on Thursday, October 12 from 1:00pm-4:00pm at Alliance’s Home Office (4600 Emperor Blvd). Limited Guardianship and Supported Decision Making Agreements will be explored with the intention of giving members more power and choice over their lives by providing the opportunity for less restrictive guardianship.

Fair Housing Training

Providers are invited to attend a free training by the Fair Housing Project titled “Fair Housing and Reasonable Accommodations for Service Providers” from 10:00am-noon on Tuesday, October 17 at the Old Wilmington Road Neighborhood Resource Center (Community Room), 500 Campbell Terrance in Fayetteville. Learn more about the training topics and register.

Information Regarding September 26 Checkwrite

There was an issue with Outlook when EFT remittances related to Medicaid payments were being processed. The payments were processed timely and you will receive payment according to the checkwrite schedule; however you will not receive the remittance advice via email. If you need a copy of the remittance advice please contact your Claims Specialist or email AccountsPayable@AllianceBHC.org.

Next All-Provider Meeting

The next Alliance All-Provider Meeting will be held on Wednesday, September 27 from 1:00-3:00pm at the Alliance Home Office. Access the agenda.

New RFP Posted to Alliance Website

IRIS Maintenance

IRIS will be unavailable on Wednesday, September 13 from noon-5:00pm to allow for maintenance. Questions can be directed to the Provider HelpDesk at (919) 651-8500, and we apologize for any inconvenience.