October 1, 2024 Edition 15

The monthly Provider Insider Newsletter will differ from the Network Communication Bulletins by offering an avenue to highlight community happenings across our catchment area. We will share information on various projects Trillium is working on within our local communities and introduce new skill development/training opportunities available to providers.

• Provider Spotlight: ICGH
• Welcome New Providers!
• Provider News
• Community Involvement
• Provider Resources
• New Opportunities
• Provider Knowledge
• In Case You Missed It 

Provider Spotlight

ICGH

ICGH, originally Integrated Care of Greater Hickory, is proud to be at the forefront of offering compassionate, evidence-based care to individuals struggling with mental health and substance use disorders across North Carolina. Since inception as a PCMH in 2006 as Rudisill Family Practice and Behavioral Health Services, ICGH has evolved into a comprehensive network of behavioral health treatment centers, providing critical care to individuals of all ages.

ICGH continues to expand its reach and services. Most notably, they are opening a new inpatient facility at Carolina Wellness Centers in Sea Level, NC, which will house 104 beds dedicated to behavioral health and substance use disorder treatment. This facility will offer detox, crisis management, medication-assisted treatment, and peer support, as well as specialized services for children, adolescents, and adults.

In addition, the regional outpatient clinic in Morehead City has opened two new recovery homes, extending their commitment to long-term recovery and support for individuals seeking stability after treatment. The Day One Recovery Homes provide a safe, supportive environment that emphasizes peer support, life skills training, and treatment services.

ICGH is deeply committed to addressing the opioid crisis and mental health challenges in North Carolina. ICGH operates mobile medical units, bringing essential medical and behavioral health care to underserved communities across the state. These units provide care to individuals who may face barriers to traditional healthcare settings, ensuring that no one is left behind in their journey to recovery.

Online program offers low-barrier medication-assisted treatment (MAT) for opioid use disorder, and we host Medication-Assisted 12 Step meetings to further support individuals in their recovery. ICGH also leads harm reduction efforts to reduce overdose deaths and connect individuals to the care and resources they need.

As an accredited provider, ICGH offers extensive training for healthcare professionals, government agencies, and the community. Their programs include Wellness Recovery Action Planning (WRAP), Certified Peer Support Specialist training, and certifications for direct care staff. They are committed to educating the next generation of healthcare providers while promoting best practices in behavioral health care.

At ICGH, they believe in promoting self-sufficiency and recovery, not just treatment. Their patient-centered, integrated care model supports individuals in making pro-social life choices, achieving personal goals, and overcoming challenges related to mental illness and substance use disorders. They provide a range of services, from intensive outpatient care to residential treatment, with the goal of ensuring long-term recovery and community reintegration.

For more information about ICGH, services, or to refer a client, please visit their website or send an email.

If you or a fellow provider are interested in sharing your story, please contact us at info@trilliumnc.org. Thank you for all you do for our members!



Tailored Plan Launch Flexibilities Extended for TP Medicaid and Medicaid Direct

The North Carolina Department of Health and Human Services (NCDHHS) launched the Behavioral Health and I/DD Tailored Plans on July 1, 2024. Tailored Plans are designed to service the complex needs of individuals with significant behavioral health disorders, I/DD, and Traumatic Brain Injuries (TBI). Tailored Plan will also serve uninsured individuals that receive state-funded services, regardless of their diagnosis, along with those remaining in NC Medicaid Direct. Beneficiaries covered by the Trillium Tailored Plan will continue to receive behavioral health, I/DD, TBI, and physical health care. The Trillium Tailored Plan will also cover pharmacy and other services for Members in the plan.

To continue to allow for implementation of the Tailored Plan to occur without members losing services, and to ensure providers are paid in a timely manner, Trillium will extend the transition of care flexibilities for services that require authorization. The Tailored Plan Launch flexibilities will be extended through 1/31/2025. All services provided are subject to a post payment review to assure that medical necessity was met at the time of service delivery and all clinical information must still be completed as required by policy. All required documentation per the Clinical Coverage Policy and the Trillium Benefit Plan is expected to be uploaded in Provider Direct.

Read More Here



North Carolina Division of Mental Health, Developmental Disabilities, and Substance Use Services (DMHDDSUS) Celebrates Behavioral Health Statewide Central Availability Navigator (BH SCAN) Successes

North Carolina's Behavioral Health Statewide Central Availability Navigator (BH SCAN) is an online centralized bed registry with a daily inventory of available beds to help providers more efficiently find and refer people to appropriate treatment. This HIPAA-compliant, cloud-based solution is available 24/7 and has the potential to reduce long stays in emergency departments. 

Since going live in January 2023, 53 inpatient treatment providers, encompassing close to 4,000 licensed beds throughout the state, and 91 referring organizations have been onboarded into the system. North Carolina's BH SCAN network is one of the most engaged networks in the country, with over 83% of facilities updating daily.

For more information or to determine if your facility is eligible to participate in the BH SCAN network, please send your contact information, the name of your facility, and the type of service provided to: bh_scan@dhhs.nc.gov.



Community Involvement

Trillium Health Resources Awards $150,000 to Malachi House II

Trillium Health Resources awarded $150,000 on September 11 to Malachi House II. Located in Greensboro, the residential program provides food, clothing, and shelter to men experiencing substance or opioid use disorder. The funding from Trillium will support Medicaid members or state-funded recipients living in our region.

In order to graduate from Malachi House II, each resident must complete a chemical dependency education program and a minimum of six courses of group studies including vocational training and relapse prevention. This helps provide the proper preparation in order to contribute back to their communities upon departure.

“We are grateful for the collaboration of Trillium Health Resources which will allow us to continue to serve men from marginalized communities in the Guilford County area who need Substance Abuse Recovery and Mental Health services,” shared James Speight, executive director and founder of Malachi House II.



News Release



Trillium Health Resources Awards School-Based Therapy Contracts

Trillium Health Resources awarded contracts to two providers to offer school-based therapy services. Pinnacle Family Services will operate in schools located in Moore and Randolph counties, and Southeastern Integrated Care, LLC will serve Robeson County.

Providers were selected after a Request for Proposal (RFP) selection process. Applicants were expected to serve individuals in Medicaid, have experience providing clinical outpatient behavioral health services to children and adolescents, and ability to work closely with the Local Education Agency (LEA).

“The schools are our partners in reaching families to improve access to mental health care for children,” stated Cecelia Peers, Regional Vice President. “Maintaining school-based therapy is one way for us to accomplish our shared mission that students receive the support they need in a safe and convenient location.”

Read More Here

Trillium Town Hall Provider Feedback and Questions

Rate Strategy

Trillium has strived to maintain provider rates for services through consolidation. We have been actively seeking funding to support the higher of rates model with the Department but have been unable to obtain the funding to support a model that would streamline rates giving providers the highest rate of the 3 legacy LME/MCO's. Due to the lack of funding, it requires provider rates to be set either at the member level or the site level to ensure we maintain the rates from legacy entities. We understand that provider rates at the member or site level is not ideal and more complicated, but at this time, we are unable to move to one fee schedule for all 3 legacy entities.

Hardship Payments

Trillium's hardship process supports our providers when they have reached a financial hardship status for various reasons. Trillium's process supports providers from start to finish through the process. A provider may claim a hardship payment via email communication to the Financial Hardship team at TrilliumFinance@TrilliumNC.org due to delays in claims processing or other operational concerns. Please view the Provider Hardship Payment Request Form here.

Tickets

Due to consolidation activities and Tailored Plan launch, Trillium experienced a high volume of provider emails or tickets sent to the Network Services Ticket email address: (NetworkServicesSupport@TrilliumNC.org). Provider tickets that are sent to Trillium are reviewed by a team of subject matter experts and sometimes requires extensive research and cross-functional collaboration between multiple departments. Our goal is to work towards a positive resolution and outcomes for our providers; therefore, there may be a delay in response time.

Trillium encourages behavioral health providers to connect with their Provider Relations and Engagement Coordinators by email and/or by calling our Provider Support Service Line. Trillium is working towards improving our level of customer service and is confident that this new process will provide additional support for your agency. To locate the name of your coordinator, please visit this link to view the alphabetical listing of Provider Relations Assignment Listing. Trillium continues to monitor our staff's response time to answer provider's questions through various dashboards. Our goal is to continue to adjust and make improvements to our processes which includes our response time in answering provider questions.

Since September 1, Network has been responding to tickets within one business day. Our goal is to resolve the issue for providers as quickly as possible. We have closed more than half the tickets in 4 days or less but there are tickets with issues that are more complex and require additional time. Trillium is committed to improving provider experience.

How to Look Up Tailored Care Management Agencies in NCTracks:

On June 26, 2024, Trillium facilitated a Tailored Plan Provider Session and reviewed Tailored Care Management. Trillium encourages providers to visit our Tailored Plan Trillium Training for further guidance and education about this service definition. NCTRACKS has provided a resource to search a Member's Tailored Plan Care Agency. Go to Home of NCTRACKS.

Select Provider User Guides & Trainings located on the left side of the webpage; then select User Guide & Fact Sheet, and the guide is located under the subheading: Prior Approval. The guide is called: Recipient Eligibility Verification Participant User Guide. Please review page 5 in the guide under 2.3.2 Individual Eligibility Response.

iOptions

TCM Assignment for 1915i:

For iOption TCM providers need to complete the ISP/Care PLan and the 1915i assessment at the same time to expedite 1915i services and avoid disruptions in services.

TCM Assignments can be verified in NCTracks.

• Sign into NCTRACKS
• Enter the member's Medicaid ID# in the Recipient ID box
• Enter C-DNDS-ID in the ID type box, then click Find
• Once the member search results appear, click on the Recipient ID#
• Click on the Enrollment tab
• Scroll down and click on the current date range
• Enrollment Detail box will pop up
• Click on the Tailored Care Manager NPI numbers in blue to see the assigned TCM

If Trillium is the TCM, the PCP/Provider Request for Care Manager Name or Assignment Referral Form can be submitted to identify the Trillium TC staff assigned to the member.

If Trillium is the TCM but does not have staff assigned yet, the clinical support team (CST) will submit the referral for TCM services. CST will alert the referring person that a referral has been submitted. The period from the CST's submission of the referral for TCM to the assignment is 3 to 5 business days. If there is a TCM assigned, the CST will contact the referring person and provide the name of the TCM. If there is no TCM assigned, the CST will alert the referring person the referral for TCM was declined.

1915i Auth:

When the TCM learns the member has qualified, they must then request an authorization for 1915i services. To request an authorization for 1915i services, TCM will need to upload Member's ISP/Care Plan in Clinical Docs via Provider Direct and submit a 1915i Submission/Auth Request to UM. The request will be processed within UM Processing Timeframes. Submitters will receive notice via email once the authorization is entered.

Inpatient Discharges:

It is important the TCM ensure a timely response for members discharging from inpatient care. For members that qualify for TCM, the TCM provider may complete and submit an interim plan of care to Trillium. TCM must then complete the full Care Plan/ISP within 60 days of eligibility determination for 1915i services.

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Please note: the Brunswick Re-Entry Simulation originally scheduled for September 24, 2024 has been moved to November 19, 2024.



Hispanic Heritage Awareness Month

Hispanic Heritage Month is celebrated September 15-October 15 to provide awareness of the rich histories, cultures, and contributions of Hispanic and Latino communities in North Carolina and beyond.

Hispanic/Latino communities face unique barriers to mental health care, including lack of access to resources and services that are culturally and linguistically appropriate, experiences of structural racism and discrimination, and stigma about seeking mental health treatment.

In response, last year DMHDDSUS expanded Spanish-language services, and the 988 Suicide and Crisis Lifeline now includes 24/7 Spanish chat and text options. 

Network Communication Bulletins 2024

Click above for more information.

Have Questions/Need Support?

If you have questions, need additional information, or require technical assistance, please contact our Network Management Department at NetworkServicesSupport@TrilliumNC.org or call Provider Support Services at 1-855-250-1539 during the hours of 7 a.m.–6 p.m. EST, Monday–Saturday. 

We appreciate your commitment to helping us achieve this mission by meeting the needs of members!

Provider Insider is a newsletter for the Trillium Health Resources provider community. Please send comments and suggestions about this publication and its contents to NetworkServicesSupport@TrilliumNC.org.