 |
|
Dear Benchmarks' Members,
We have a couple of updates that have come in from DHHS and others that we wanted to be sure to share with you!
Take care of each other and stay safe and healthy!
The Benchmarks' Team
|
|
|
|
HRSA COVID-19 Uninsured Program Portal
Good afternoon:
The federal Department of Health and Human Services (HHS) yesterday launched the Health Resources & Services Administration (HRSA)
COVID-19 Uninsured Program Portal
at
coviduninsuredclaim.linkhealth.com
. Health care providers and hospitals can use the portal to electronically request reimbursement for claims associated with COVID-19 testing and treatment of uninsured patients retroactive to Feb. 4, 2020. These relief funds are provided as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Families First Coronavirus Response Act (FFCRA).
Thank you for your dedication and commitment to ensure our North Carolina Medicaid beneficiaries receive the services and treatment they need during the COVID-19 pandemic.
NC Medicaid COVID-19 Bulletin Article Summary (#62-69)
The NC Division of Health Benefits (DHB) has recently published Medicaid Bulletin articles related to COVID-19. Below are exerts or summaries of some of the most recent articles and links for more details. All articles may be found on the
DHB website
.
SPECIAL BULLETIN COVID-19 #63: NC Innovations and NC TBI Waivers Community-Based Services (HCBS) Flexibilities - Retainer Payments
NC Medicaid has implemented flexibilities on how Medicaid providers and beneficiaries may access and receive Medicaid services in the wake of COVID-19. Retainer payments may be made for direct care providers of services that include habilitation or personal care that are currently authorized in the Individual Support Plan (ISP). Retainer payments can not add up to more than the total number of hours per service approved in the Innovation or TBI Waiver beneficiary's ISP.
Services included
SPECIAL BULLETIN COVID-19 #64: Telehealth and Virtual Patient Communications Clinical Policy Modifications - Health and Behavior Intervention Visits Provided by Local Health Departments
NC Medicaid has temporarily enabled licensed clinical social workers at Local Health Departments to conduct Health and Behavior Intervention visits for pregnant and postpartum women who have serious psychosocial needs via telemedicine. Specific guidance related to billing and coding is detailed in the section "Temporary Modifications to Attachment A."
Read more
SPECIAL BULLETIN COVID-19 #65: Telehealth and Virtual Patient Communications Clinical Policy Modifications - Postpartum Depression Screening
NC Medicaid has temporarily enabled providers to conduct postpartum depression screenings of postpartum women via several remote modalities in light of social distancing measures that may prevent in-person visits.
Billing and coding details
SPECIAL BULLETIN COVID-19 #66: Telehealth and Virtual Patient Communications Clinical Policy Modifications - Well Child Visits
NC Medicaid is temporarily adding telemedicine coverage for providers to conduct Well Child Visits with patients to ensure the provision of comprehensive and preventive health care services for children under age 21. Providers are encouraged to continue providing well child visits, immunizations and or preventive care during the pandemic. For additional information on the delivery of Well Child Visits during the pandemic, see
guidance from the American Academy of Pediatrics
.
More information
SPECIAL BULLETIN COVID-19 #67: Telehealth and Virtual Patient Communications Clinical Policy Modifications - Outpatient Respiratory Therapy
NC Medicaid has eliminated the restriction that teletherapy services cannot be conducted via "video cell phone interactions." These services can now be delivered via any HIPAA-compliant, secure technology with audio and video capabilities, including (but not limited to) smart phones, tablets and computers.
More details
SPECIAL BULLETIN COVID-19 #68: Expedited Hardship Advances and Retroactive Targeted Rate Increases for Skilled Nursing Facilities and Adult Care Homes Serving COVID-positive Patients
NC Medicaid is directing increased financial assistance to North Carolina Skilled Nursing Facilities (SNF) and Adult Care Homes (ACH) to support addressing the increased costs of caring for COVID positive (COVID+) residents in a congregate care setting.
Details of targeted assistance
SPECIAL BULLETIN COVID-19 #69: Clarification to Bulletin #15 Medicaid and NC Health Choice Temporary Flexibilities - 1135 Waiver Provisions and Replace Effective Dates Stated in Bulletins #2, #10 & #11
The Centers for Medicare & Medicaid Services (CMS) has granted NC Medicaid the authority to temporarily modify Medicaid and NC Health Choice policies including reimbursement for Medically Necessary Services without Prior Authorizations. This Bulletin:
- Clarifies which specific Prior Authorizations are being lifted on the March 1, 2020, effective date stated in SPECIAL BULLETIN COVID-19 #15: Medicaid and NC Health Choice Temporary Flexibilities - 1135 Waiver Provisions (posted March 24, 2020)
- References all relevant Prior Authorization information included in other Bulletins
- Replaces the effective dates originally stated in the following Bulletins:
- SPECIAL BULLETIN COVID-19 #2: General Guidance and Policy Modifications (posted Mar 13, 2020)
- SPECIAL BULLETIN COVID-19 #10: Durable Medical Equipment: Temporary Flexibilities Effective March 23, 2020 (posted Mar 24, 2020)
- SPECIAL BULLETIN COVID-19 #11: Outpatient Specialized Therapies Temporary Flexibilities (posted Mar 24, 2020)
Three New Medicaid Bulletin Articles Available
The NC Division of Health Benefits (DHB) has recently published three new Medicaid Bulletin articles. Below are exerts or summaries of some of the most recent articles and links for more details. All articles may be found on the
DHB website
.
Cefiderocol for Injection, for Intravenous Use (Fetroja®) HCPCS Code J3490: Billing Guidelines
Effective with date of service Feb. 24, 2020, the Medicaid and NC Health Choice programs cover cefiderocol for injection, for intravenous use (Fetroja®) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
More information
Cetirizine Hydrochloride Injection, for Intravenous Use (Quzyttir™) HCPCS Code J3490: Billing Guidelines
Effective with date of service Feb. 19, 2020, the Medicaid and NC Health Choice programs cover cetirizine hydrochloride injection, for intravenous use (Quzyttir™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code J3490 - Unclassified drugs.
Details
Trastuzumab-Qyyp for Injection, for Intravenous Use (Trazimera™) HCPCS Code Q5116: Billing Guidelines
Effective with date of service Feb. 15, 2020, the Medicaid and NC Health Choice programs cover trastuzumab-qyyp for injection, for intravenous use (Trazimera™) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code Q5116 - Injection, trastuzumab-qyyp, biosimilar, (trazimera), 10 mg.
Read more
|
COVID-19: Public Health Forum - Friday, 12:30 - 1:30
Participant Log-In Information
The Division of Public Health has asked to be sure your members are invited to participate in the Friday forums for providers with NC Division of Public Health subject matter experts. Please note that the dial-in information below is different from the previous forums held on Tuesdays.
The forums are each Friday from 12:30 - 1:30.
Webinar access through your computer:
Traditional audio dial-in:
For audio-only access (mobile)
Dial +16465588656,,705979628#
For audio-only access (office telephone)
Dial (646) 558-8656 or (301) 715-8592
Webinar ID: 705 979 628
|
May 2020 Provider Training Available
Registration is open for the May 2020 instructor-led provider training courses listed below. Slots are limited. WebEx courses can be attended remotely from any location with a telephone, computer and internet connection. Please note that as of January 1, 2020, the WebEx information has changed. See the Training Enrollment Instructions below for details.
Prior Approval Institutional (WebEx)
Tuesday, May 5, 2020, 9:30 a.m. - 12:00 p.m.
This course will guide the authorized user through the process of submitting Prior Approval requests, to help ensure compliance with Medicaid clinical coverage policy and medical necessity. This course will also detail how to inquire about Prior Approval requests to determine their status. At the end of this training, the authorized user will be able to:
- Submit prior approval requests
- Complete prior approval inquiries
Submitting an Institutional Claim (WebEx)
Tuesday, May 5, 2020, 1:00 p.m. - 4:00 p.m.
This course will guide the authorized user through the process of submitting an institutional (UB-04/837I) claim using the NCTracks web portal. The authorized user will learn what they need to know to file a claim and how to easily navigate the claims entry screens. At the end of this training, the authorized user will be able to:
- Create an initial claim
- Save a claim draft
- Use the Claims Draft Search tool
- Submit a claim
- View results of a claim submission
- Perform a claim status search
- Copy a claim
- Resubmit a claim
- Void or replace a prior claim
Training Enrollment Instructions
Providers can register for these courses in SkillPort, the NCTracks Learning Management System. Log onto the secure NCTracks Provider Portal and click Provider Training to access SkillPort. Open the folder labeled Provider Computer-Based Training (CBT) and Instructor Led Training (ILT). The courses can be found in the sub-folder labeled ILTs: Remote via WebEx.
To access WebEx online training sessions:
If this is your first time using the new GDIT Web Meeting, it is suggested that you begin the process 15 minutes prior to the start of the call. This will allow you sufficient time to download the required software to access the Web Meeting. To hear the audio portion of the class, dial 1-866-523-9994. Enter Access code 711 563 557.
Refer to the
Provider Training page
of the public Provider Portal for specific instructions on how to use SkillPort. The Provider Training page also includes a quick reference regarding Java, which is required for the use of SkillPort.
|
Mailing and Delivery Fee Claims for Pharmacies
Beginning April 27, 2020 pharmacies can indicate that a mailing or delivery fee is requested by submitting a Level of Service (NCPDP Field 418-DI) equal to 02 at a rate of $1.50 (for prescriptions that were mailed) or 06 at a rate of $3.00 (for prescriptions that were delivered via courier or other person to person delivery). Please note:
- Pharmacies cannot request an emergency supply and a delivery fee on the same claim
- Providers are limited to one mail or delivery fee, per beneficiary, per pharmacy NPI, per day
- Providers can retroactively bill for a delivery fee with a dispensing date of April 27, 2020 and after.
- No more than one delivery fee will be paid on a single claim
- Denied pharmacy claims will not pay a delivery fee
|
COVID-19 Provider Update #24: Credentialing Change
Correction
The memo sent yesterday on credentialing changes was incomplete. The full memo can be found here:
In response to the COVID-19 pandemic, Eastpointe is working to ease the administrative burden for agencies related to the practitioner credentialing process. The following guidance is retroactive to March 10, 2020 and will remain in place throughout the declared State of Emergency or until further notice.
Please note:
Upon approval of Provisional Credentialing,the provider will have 60 calendar days to submit a completed application to CAQH to obtain full credentialing.
Provisional Credentialing Process
The Provisional Credentialing Packet must include:
- A written request, on the agency's letterhead, for provisional credentialing. This request must include the practitioner's full name, DOB and social security number.
- A copy of the agency's current Certificate of Insurance, stating that the practitioner is covered.
- A copy of the practitioner's current licensure(s).
- A copy of the practitioner supervision contract for associate level practitioners, physician's assistants and nurse practitioners.
- A completed criminal background check release form. (This document can be found on our website. It is in the Credentialing section of the linked page.)
Please note that provisional credentialing applies only to practitioners who are linked with a provider who has a full Medicaid contract with Eastpointe. The practitioner must be enrolled and active in NCTRACKS and affiliated with the agency that is submitting the Provisional Credentialing application.
The Provisional Credentialing application will be reviewed by our Associate Medical Director to determine approval.
The Provider Relations Account Representative assigned to your agency will notify the provider and practitioner in writing when provisional credentialing has been approved.
As always, thank you to all of our providers who continue to work diligently during this crisis to deliver the best possible care for our members. We appreciate all of your efforts.
|
COVID-19 Screening Tools and Questionnaire
We want to send a
HUGE THANK YOU to Celeste Dominguez and Children's Hope Alliance team for sharing the following COVID-19 screening tools and questionnaire for your agency to consider while in the midst of this pandemic!
|
Keep Families Strong & Thriving With Tip Sheets on Everyday Parenting Topics
Help caregivers overcome challenges and stressors by providing knowledge and support.
- Keeping Your Family Strong
- Managing Stress
- Managing Finances
- Building Resilience in Children and Teens
- Dealing With Temper Tantrums
- And More!
|
|
|
|
|
|
