supporting health and recovery...million people as we help them live their lives to the fullest...
TRANSCRIPT
Partnership in PrintVolume X, Issue I April 2015
VOLUME XI ISSUE I MAY 2016
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02.
03.
04.
05.
WHAT’S INSIDE? MAT Services Expand in CT - page 2
Provider Frequently AskedQuestions - pages 4 & 5
Beacon Health OptionsMerger - page 3
Integration & the Collaborative Care Model - page 6
Provider Bulletin Rewind -page 7
Supporting Health and Recovery
VOLUME XI ISSUE I MAY 2016
A Growing Need
The need for MAT services cannot be ignored. Each day 6,748 Americans seek treatment in Emergency Departments for misuse or abuse of drugs**. In 2010, drug overdose was the leading cause of death in the United States for people ages 25-64***. The CT BHP is working to expand available MAT resources to support our members with substance use needs.
* New England Journal of Medicine Vol 363
** CDC Drug Overdose Fact Sheet, 2013
*** CDC National Vital Statistics Report Vol 54
been shown to be effective with helping people with substance use disorders recover in a safe and efficient manner. For instance, pregnant women receiving MAT services had significantly shorter stays for substance use treatment than their peers who did not receive MAT services (10.0 days vs 17.5 days, respectively)*. In pursuit of our mission to help people live their lives to the fullest potential, the CT BHP has taken action to educate and empower local providers in hopes of expanding our network of available MAT resources in CT. Starting in November 2015, the CT BHP Provider Relations Department began making outreach calls to gather feedback and assess interest from CT HUSKY providers. While these outreach efforts... Continued on Page 6...
Turn on the news today and you’re likely to hear about the devastation that opioid addiction is inflicting on our communities. Regardless of who you are, you probably know someone who has been impacted by opioid addiction. In recent years, drug overdose was the leading cause of injury death in the US – causing more deaths than motor vehicle accidents among individuals 25-64 years old***. Right now, there are an estimated 2 million Americans addicted to opioids and that number continues to grow. Medication Assisted Treatment (MAT) is a comprehensive whole-person approach to care that is comprised of evidence-based behavioral therapies and approved medications. This combination has
CT BHP Responds to Growing Needs for MAT Services
SERVICES IN CONNECTICUT
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VOLUME XI ISSUE I MAY 2016
Beacon Health Options now has over 5,000 employees across the US and UK. We proudly serve more than 48 million people as we help them live their lives to the fullest potential.
Together We Achieve More In 2014, Beacon Health Strategies, LLC and ValueOptions, Inc. announced their plan to merge into one managed behavioral healthcare company. As of December 9, 2015, the company’s new legal name is Beacon Health Options. The combined company serves over 48 million people across all 50 states as well as the United Kingdom. Separately, Beacon Health Strategies and ValueOptions have long been recognized as leaders in the behavioral health management industry. Together, the mission will remain the same: to provide a superior approach to behavioral health management, while maintaining a commitment to the vision of helping people live their lives to their fullest potential. This change will not impact current CT BHP processes and/or procedures.
As branding continues, you may notice some visual updates including logo changes on correspondence, websites, etc. The only significant change for providers will be updates to our internal staff and group email addresses*. We have transitioned from @valueoptions.com to @beaconhealthoptions.com. The Provider Relations email has also been updated to [email protected]. Providers who currently have the Provider Relations or CT BHP staff email addresses in their contact lists should update the contact information at their earliest convenience.
*Any emails sent ending in @valueoptions.com will still be routed to the new email address until further notice.
ValueOptions Merges with Beacon Health Strategies
03 Supporting Members in Wellness & RecoveryPAR TNERSHIP IN PRINT PAGE
We help people live their lives to the fullest potential.
VOLUME XI ISSUE I MAY 2016
There are two ways to access your ProviderConnect password when you’re locked out. The fastest way to retrieve your password is to click the ‘Forgot Your Password?’ link on the log in page. You will then be asked to confirm your User ID and then answer your personal security question. After this, you will be able to create a new password that can be used to log into the system. If you have trouble with the above process, you can call the CT BHP and speak with Provider Relations at 1(877)552-8247. Please Note: If you do not log into the ProviderConnect system at least once every 30 days, you will be asked to create a new password on your next login attempt. Also, you have the opportunity to change your password and security question by clicking on the Profile tab inside ProviderConnect.Continued on Page 5...
I’m locked out of ProviderConnect. What should I do?
helping our members live their lives to the fullest potential. Joining the CMAP network is easy and begins with you by completing an online enrollment application at www.CTDSSMAP.com. The enrollment process is managed by HP Enterprise Services so if you have questions about enrollment or fee schedules, please contact them directly at 1(800)842-8440.
First, congratulations on making the decision to join the CT Medical Assistance Program (CMAP) network. Your services are greatly needed and will contribute to our mission of
I want to join the CT Medicaid network. Where do I begin?
A very common question that we receive relates to the ability of providers to charge Medicaid members for missed appointments. The Centers for Medicare & Medicaid Services (CMS) states that Medicaid clients must not be charged for broken, missed, or cancelled appointments. Local State regulations also have provisions that ensure no client is billed in excess of the amount paid by the CT Medical Assistance Program (CMAP). A common misconception is that Providers can have members sign agreements stating they will pay for missed or cancelled appointments. Even with a signed agreement in place, regulations protect members from being charged for services they did not receive. If a provider has imposed charges for missed appointments, any money paid by the member must be returned immediately. For more information, please see Provider Bulletin 2015-05.
Can I bill for missed appointments?
04Answers to our most common Provider questions
PROVIDER INSIDERPAR TNERSHIP IN PRINTPAGE
reviewing the authorization schedules, which are posted on the CT BHP website. These schedules detail the types of services that can be delivered by distinct provider licensures under several different types of care.
There are many reasons why your claims may be denied. HP Enterprise Services (HPES) is the fiscal agent for the State of CT and they manage the claims process through their website, www.CTDSSMAP.com. If you are having specific questions about a claim that is being denied, please contact HPES directly at 1(800)842-8440 for assistance. You may also benefit from
My claims are getting denied. How do I get help?
There are a variety of resources that you can use to ensure that your staff is ready and able to obtain authorizations. On the provider homepage, you can access our authorization templates, ProviderConnect user manuals, and training videos. If your staff has more specific needs, please contact Provider Relations at 1(877)552-8247 or [email protected]. Provider Relations can address questions or concerns using a variety of approaches including email, phone call, webinar, and site visits. We are committed to your success and appreciate every opportunity to educate and empower our provider community.
My sta� needs training on authorizations. How can they get help?
Sometimes a client you are seeing may have more than one type of insurance coverage. For instance, the client may have primary commercial or Medicare coverage and secondary HUSKY (Medicaid) insurance. These situations can become complicated when a provider is not aware of a member’s HUSKY eligibility until after they have already started providing services. To prevent this confusion and potential complications, the CT BHP recommends that providers search the HPES Interchange portal for each of their clients before starting services for them. If a client is found to have HUSKY insurance as primary or secondary coverage, it is recommended that the provider obtain authorization from the CT BHP at the start of services. Doing this will ensure that you will receive compensation by the Medicaid program if/when needed. For more information on checking member eligibility, please call HPES at 1(800)842-8440.
What should I do if a Member has HUSKY as secondary insurance?
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Integration has become a popular buzzword in mental health care, but what does it mean? Such a plethora of definitions leads to a lack of clarity about what activities need to take place including where to really make a difference in improved health for people with mental illness, and who should be involved. Amidst the noise, the good news is that the weight of evidence points to an answer - the collaborative care model.
The collaborative care model constitutes five key components: 1. Patient-centered care 2. Population-based care 3. Measurement-based care 4. Evidence-based care 5. Accountable care
All five pillars are required for the collaborative care model to be effective. When organizations successfully operationalize this model, studies have pointed to
An Introduction to Integrated Care and the Collaborative Care Modelimproved outcomes and cost-savings, both for medical and behavioral health. Due to our multiple touch points across the continuum of care, Beacon Health Options is in a unique position to drive integration in specialty care as well as primary care settings. To learn more about the collaborative care model, and Beacon’s call to action for integration, we invite you to read our white paper on the topic, titled “Integration” by clicking here.
MAT Services Expand in CT...
MEDICAID PROVIDER LOCATIONSMedication Assisted Treatment
continue, the CT BHP has expanded efforts by offering MAT provider workshops and producing informational materials for interested providers. We remain vigilant in our commitment to increasing MAT resources in CT to support our members with substance use needs. Want to get involved? If you or a colleague are interested in receiving more information on medication assisted treatment, please contact the CT BHP Provider Relations Department at 1(877)552-8247. The CT BHP Chief Medical Director, Dr. Sherrie Sharp, is also available for consultations and inquiries at (860)707-1165. Additionally, the Substance Abuse and Mental Health Services Administration (SAMHSA) website has a wealth of information and additional resources here.
Additional MAT Resources: If you are looking for more information on MAT services, providers, or regulations, you can visit the Medication Assisted
Treatment page of the DMHAS website to get updated information. Also, if you or someone you know needs assistance seeking opioid treatment, DMHAS is now offering a
toll-free phone number for people seeking opioid treatment and services. Call 1-800-563-4086 to be connected to a local walk-in assessment center in your area.
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Visit CT BHP Website
Visit Achieve Solutions
BULLETIN REWIND
Provider Bulletin 2016-18To: General HospitalsSubject: Payment for Inpatient Hospital Care Provided to Inmates
Provider Bulletin 2016-14To: All CT BHP ProvidersSubject: Expedited Medicaid Eligibility Processing for Individuals with Medical Emergencies
Provider Bulletin 2016-11To: Pharmacy, Physician, and APRN ProvidersSubject: Clarification of Changes to Narcan Prescribing
Provider Bulletin 2016-10To: Pharmacy, Physician and APRN ProvidersSubject: Prescribing of Opioid Antagonists by Certified Pharmacists
Provider Bulletin 2016-08To: Behavioral Health Clinics, Enhanced Care Clinics and Hospital Outpatient DepartmentsSubject: Targeted Case Management for Adults with Serious and Chronic Mental Illness or Substance Use Disorders
Stay up to date with the latest CT BHP Provider Alerts and Bulletins. Click on any of the headings below to view the entire document. All other Alerts and Notices can be found at the CT BHP webiste: www.CTBHP.com.
Our partners include Harvard University, McLean Hospital, theUniversity of Kansas School of Medicine, and Boston College Center for Work & Family. Content is reviewed and refreshedon a regular basis. Providers have found the Achieve Solutions online library to be a valuable source of material to share with their members and families. Members can also access the website themselves.
Achieve Solutions is an award winning online library of information about behavioral healthcare. This site offers behavioral health information in a convenient,confidential manner with interactive tools and other resources to help individuals and family membersresolve personal concerns. The site features materials in both English and Spanish. Achieve Solutions includes more than 3,000 feature articles acrossmore than 200 topics and it partners with experts to develop articles, quizzes and trainings.
FEATURE: Providers and Members Achieve More with Achieve Solutions
One of the most important functions of the CT BHP Provider Relations/Network Operations Department is to maintain an up-to-date, accurate provider database. The practice information in our provider files is a critical component of authorizing care and supporting our online ReferralConnect application. The ReferralConnect application pulls data from our provider files and assists Medicaid members and providers in finding available behavioral health care throughout Connecticut.
While this is a valuable resource, contact information, practice location information and referral status often change. We strongly urge providers to contact us directly with any changes to their practice to ensure our members have up-to-date and accurate information. Please contact Provider Relations to update your address, phone number, referral status, or any other changes to your information. We can be contacted the following ways:Phone: 1(877)552-8247Fax: 1(855)[email protected]
Practice Updates: We Are Here for You
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