Information for Providers of Services

Sandhills Center is committed to insuring the provision of quality services and supports to consumers with mental health, developmental disabilities, and substance abuse needs. Inherent to this, is consumer choice and a community of providers that are responsive to consumer needs and preferences.

Sandhills Center Network Operations will provide information in a timely manner  to ensure that providers have access to all state and federal regulations, Division guidelines, and training opportunities for the continued development and maintenance of quality and efficient services for our consumers.

Provider Connect User Guide

Whats New

Memos

Date Posted

Link to Document (click on link below)

12/2/2011   December Medicaid Bulletin
12/2/2011   DMH/DD/SAS Announcements Posted 11/22/11, 11/23/11 and 11/28/11

Provider Enrollment/Credentialing

Medicaid Credentialing and Re-Credentialing Criteria

IPRS Credentialing and Re-Credentialing Criteria

Questions? Submit Provider Enrollment Questions Here

Provider Enrollment/Credentialing Instructions

Sandhills Center (SHC), a Local Management Entity (LME) has been selected as a North Carolina Medicaid 1915 (b/c) waiver site. The 1915 (b/c) Waivers establish the Sandhills Center Network as a single Prepaid Inpatient Health Plan (PIHP) through which mental health, substance abuse, and developmental disabilities services will be authorized and paid.

After July 1, 2012, SHC will handle all authorizations and payments to providers for all appropriately delivered Medicaid services for Medicaid enrollees from the eight SHC counties.

Effective July 1, 2012, behavioral health service providers serving Medicaid enrollees from the eight SHC counties will no longer be working with Value Options for authorizations or HP Enterprise Services for payment of services.

Medicaid providers (including individual practitioners, agencies, clinics or hospitals) located in or out of SHC’s eight county catchment area will not be able to continue receiving Medicaid authorization or payment for services for residents from the eight SHC counties under their current fee for service agreements.

In order to continue as a provider for a SHC enrollees/member who is a Medicaid recipient, behavioral health care providers must submit an application to become Contract Providers of SHC prior to March 1, 2012. Please note: Neither a current contract with SHC nor a current service agreement with Medicaid will waive the requirement for enrollment with SHC.

It is imperative that Providers who wish to continue serving SHC Medicaid enrollees & IPRS members request enrollment to be credentialed as a SHC Network Provider prior to March 1, 2012. Applications received after this date will be processed in the order received and as quickly as possible, but an effective enrollment date of July 1, 2012 cannot be guaranteed. 

As of July 1, 2012, any enrollees/members of providers who are not enrolled/credentialed in the Sandhills Provider Network as either a Medicaid and/or IPRS Provider will be offered a choice of another provider who is a current enrolled/credentialed member of the Sandhills Provider Network.

In an effort to process applications in a timely and efficient manner submit the appropriate application as follows:

·        Licensed Independent Practitioners by January 15, 2012

·        Agency/Facility by January 31, 2012

·        Hospitals by February 15, 2012

The provider enrollment/credentialing process includes the following steps:

  1. Complete the application. Refer to Selecting an Application to determine which application is appropriate to your circumstances.

  2. Print the application as a single sided document for signature by a legally Authorized Representative

  3. Retain a copy of your completed Application packet and all documentation submitted for your records.

  4.  Review, print, and sign the Trading Partner Agreement

  5. Submit completed applications and Trading Partner Agreement as stipulated on Application title page.

You will receive written notification (e-mail or letter) within 10 days regarding the status of your application.

 

Sandhills Center

A Local Management Entity of the NC Department of Health and Human Services

Victoria Whitt- Chief Executive Officer

 

 

Links

Sandhills Center Resources

Provider Directory

Provider Connect

CABHA

Direct Enrolled Providers

Provider Manual

FY 2011-2012

Medicaid Provider Manual

FY 2011-2012

Provider Memoranda

FY 2011-2012
FY 2010-2011

Provider Forms

Provider Enrollment/Credentialing

Provider Meetings

Schedule
Minutes

Provider Training Schedule

Provider Satisfaction Survey

Regulatory Compliance

Medicaid Fraud
DHHS Poster
Public Service Message

Zixmail Training

State Resources

Division of MH/DD/SAS

Communications Bulletins
Training Programs
Implementation Updates
Service Definitions
NCTOPPS
NC SNAP
Supports Intensity Scale

Division of Medical Assistance

HIPAA Transaction Companion Guides

Health Service Regulation

Community Care of NC

NC LME Regions by Counties

NC Council

Veterans Focus

Other Resources

NAMI

Value Options

SAMHSA