JULY 20, 2023 | COMMUNICATION BULLETIN 2023-24 ISSUE 3

IN THIS ISSUE: Provider Touchpoint | Provider Portal Updates: NPIs on Service Authorization Requests and Monitoring Documents Upload Feature | NCTracks Reminders: Provider Profiles, Re-credentialing/ Re-verification | Consumer Perceptions of Care Survey | Reminder: NC-TOPPS Support | Tailored Care Management Provider Manual Updates and Timely Billing | NC Medicaid 1915(i) Draft Clinical Coverage Policies Posted for Public Comment | NC Innovations Waiver Processes Trainings for TCM Providers | Open Office Hours for Providers – Authorizations | Registry of Unmet Needs Training | Person-Centered Thinking Training

Provider Touchpoint

Tomorrow, July 21, 2023, 11 a.m.-12 p.m.

The Provider Touchpoint webinar is your source for the latest information on topics that affect Vaya Health network providers. We encourage all network providers to attend. Registration is not required. The link to each webinar is published both the week prior to and the week of the event in the Provider Communication Bulletin.

NCTracks Reminders: Provider Profiles and Re-credentialing/ Re-verification

Please note the following NCTracks reminders:

NCTracks Provider Profiles

Because NCTracks provider profiles are used in claims processing, it is important to ensure your profile is accurate. If information on submitted claims does not exactly match the NCTracks profile, the claim will not be paid. If you bill via an 837 file, which requires a nine-digit ZIP code, your NCTracks provider profile must include a nine-digit ZIP code. To bill using a five-digit ZIP code, use Vaya’s Provider Portal.

NC Medicaid Re-credentialing/Re-verification

Re-credentialing/re-verification is an evaluation of a provider’s eligibility for continued participation in NC Medicaid. To avoid suspension and/or termination from the state’s Medicaid program, be sure to look for and respond to secure notifications from NCTracks to complete the re-credentialing process. If your record is suspended, claims payments will stop until you submit your re-credentialing application.

For more information, see the NCTracks Provider Re-credentialing/Re-verification page.

Consumer Perceptions of Care Survey

North Carolina’s annual Consumer Perceptions of Care Survey gives individuals who have received publicly funded behavioral health services, and their families, the opportunity to share their experiences with LME/MCOs and NCDHHS.

Adults ages 18 and older, youth ages 12-17, and parents of children under age 12 complete the confidential surveys, in English or Spanish, at their provider organizations during a specified time period each year. Survey results inform policy decisions aimed at improving the service system.

The NC Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (MHDDSAS) oversees survey administration and will contact providers directly. Vaya encourages participation in the survey and will email a reminder to participating providers prior to Aug. 14, 2023, when the survey is scheduled to open.

Reminder: NC-TOPPS Support

The NC Treatment Outcomes and Program Performance System (NC-TOPPS) is a web-based program that allows the Division of MHDDSAS to measure the quality of mental health and substance use disorder services and their impact on members’/recipients’ lives. To effectively complete and submit required NC-TOPPS interviews, please review the guidance below. 

MCO Record Numbers

Providers can now locate member/recipient record numbers in Vaya’s Provider Portal by completing a “Member Search” using the individual’s first name, last name, and date of birth. When you select a member/recipient, you will be able to see the Patient ID, which is also the MCO Record Number. For Medicaid members, this number is also available in NCTracks.

NC-TOPPS Training

Vaya offers an optional, virtual NC-TOPPS training, which is designed for new provider-based NC-TOPPS users and superusers and serves as a refresher for experienced users. A certificate of completion is available at the end of the training.

We recommend that providers who train their staff in NC-TOPPS review our training to ensure their training materials match NC-TOPPS’ and Vaya’s expectations. For more information, visit the NC-TOPPS Online Training page of Vaya’s Provider Central website. For help, contact Vaya’s NC-TOPPS superusers at [email protected].

Tailored Care Management Provider Manual Updates and Timely Billing

Until Tailored Plan launch, Vaya requires providers to submit Tailored Care Management (TCM) claims within 90 days of the date of service. Please refer to your contract for details. If issues arise that prevent you from submitting claims, immediately notify your assigned provider network contract manager.

For more information, see the updated NCDHHS TCM Provider Manual, effective July 14, 2023, and a Summary of TCM Manual Updates. If you have questions, contact your assigned provider network contract manager or [email protected].

NC Medicaid 1915(i) Draft Clinical Coverage Policies Posted for Public Comment

NC Medicaid 1915(i) draft Clinical Coverage Policies (CCPs) for Supported Employment for I/DD and TBI (CCP 8H-1) and Community Living and Supports (CCP 8H-5) are available for a 45-day public comment period. Submit comments about the proposed policies to [email protected].

Vaya will present NC Innovations Waiver processes trainings on the following dates for TCM providers supporting Innovations participants:

• July 25, 2023, 10 a.m.-12 p.m.: NC Innovations Emergency Slot Request, Invoice-Based Innovations Services, Innovations Waiver Transfer, and Innovations Waiver Slot Terminations. Join online.
• Aug. 2, 2023, 8:30 -10:30 a.m.: Appendix K Flexibilities and Resource Allocation Letters. Join online.
• Aug. 8, 2023, 2 -4 p.m.: IFDS, RADSE, and Out-of-State Travel. Join online.

Care managers working with Innovations participants should attend all four trainings. Vaya will make training recordings available for individuals who cannot attend and to help train future staff.

Vaya is offering additional virtual open office hours for providers through July 31, 2023. Providers are invited to drop in to ask questions related to authorizations and the Vaya Provider Portal. All sessions will be from 9:30 to 11 a.m. on Mondays.

To join, select the link below:

• July 24, 2023
• July 31, 2023

Prior to attending open office hours, review the recorded trainings and job aids available on the Resources page of Vaya’s Provider Central website. These resources include answers to frequent provider questions.

Reminder: Providers may not discuss member/recipient protected health information (PHI) during these calls due to the presence of multiple Vaya staff and other providers.

During this free, virtual training, Vaya staff will provide an overview of the NC Innovations Waiver and the RUN, walk participants through the RUN application process, and explore the services available through the waiver. Register online.

For more information, email [email protected].

Benchmarks will sponsor a 12-hour, in-person Person-Centered Thinking training approved by The Learning Community for Person Centered Practices. Participants will learn practical information and explore useful tools to enhance their application of person-centered practices. Only 20 slots are available.

Learn more and register online. For more information, contact Paige Wiggs, Benchmarks communications and training specialist, at 919-828-1864.