Effective 11/1 forward, providers who have received SABG allocations for FY20 and thereafter, must utilize a
modifier for SABG-related encounters. SABG funds are only to be used for allowable services identified within
AMPM Exhibit 300-2B
. Restrictions of SABG funds are outlined within
AMPM Policy 320-T
. Mercy Care will be monitoring claims for utilization of the modifier.
Providers must ensure the persons receiving these services are known to Mercy Care RBHA so claims may be adjudicated appropriately. This means providers are expected to check eligibility and submit the appropriate transactions as necessary.
Non-Title (NT) enrollments are intended for persons not enrolled with any contractor, but otherwise eligible for publicly funded behavioral health services. These are submitted through Provider Intake by using the Member Search screen.
Crisis/State-Only notifications are for cases where the member is enrolled with some other plan. This is effectively a tool to notify Mercy Care of the member so that we can request their detail from the State and administer the limited crisis/state-only benefits.
We appreciate your continued assistance, support and cooperation!