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On Wednesday, November 8, 2023, from 9 a.m. to Noon, in collaboration with all of the other prospective Tailored Plans in the state, Sandhills Center is cohosting a program highlighting the eight recognized tribes in North Carolina. There is a link to register included in the flyer, below. Please feel free to share this information.
On April 1, 2023, Sandhills Center migrated its UM software system from Alpha+ to Jiva. Service Authorization Requests (SARs) require a billing site be attached to the request, and this site must match the provider’s contract details in order for claims to be paid. In other words, the billing site listed on the SAR must be contracted for the particular service code being requested.
Alpha+ required the provider to enter the billing site correctly in order for the SAR to be submitted. If the site was incorrect, the SAR could not be submitted. As part of the transition to Jiva, providers have been able to submit SARs even if the billing site is incorrect. When this occurs, Sandhills Center UM staff receive a “soft stop” that warns them the provider site on the SAR is incorrect. This has allowed Sandhills Center to gather information to ensure all provider sites were correctly loaded into Jiva and to provide technical assistance to providers on how to correctly identify the billing site.
As of Sunday, October 22nd, providers are no longer be able to submit a SAR if the billing site attached to the SAR does not match the provider’s contract details. The provider will receive a “hard stop” informing them the SAR cannot be submitted. The SAR can be submitted when the billing provider information is correct. If you receive a hard stop and need help identifying the correct billing site, please submit a ticket to the Provider Support Portal. During this time of transition, The Sandhills Center UM department will work with providers if SARs are submitted late due to the hard stop. To guarantee your SARs will be accepted late (i.e. after the start date listed on the SAR), please reach out to your individual Sandhills Center UM reviewer or UM Director Sarah Glanville so we can work with you on late SAR submissions.
Providers who offer services that require utilization of a Person-Centered Plan (PCP) will be required to comply with the new guidance outlined in the Person-Centered Planning Guidance Document as of Wednesday, November 1, 2023.
The Guidance Document references that all who develop plans must attend a state-approved training.
To access the training on Behavioral Health Springboard's website, visit https://bhs.unc.edu under online trainings. Click on the title, "From Theory to Practice: Person-Centered Planning in NC." You will then be directed to create an account to enter the website.
Sandhills Center will provide additional information and answer questions at the upcoming Provider Forum on Wednesday, November 8, 2023, from 9 a.m. to Noon.
FOR OPIOID TREATMENT PROVIDERS
The North Carolina Department of Health and Human Services (NCDHHS) has issued a temporary licensure waiver for Opioid Treatment Programs to provide increased flexibility and promote more successful practices. The Division of Health Service Regulation (DHSR) will send information, including the Waiver Request Form, to program contacts. In addition to DHSR’s form, providers who wish to take advantage of this waiver must contact each Local Management Entity-Managed Care Organization they contract with to request a Letter of Support. To request a Letter of Support from Sandhills Center, please send an email to OTPRequest@SandhillsCenter.org, including your program’s information (Program name, site address, and name of the Point of Contact) and Diversion Plan. For additional information, see the NCDHHS Overview of 2023 Temporary Waiver presentation.
Claims Timeline Changes
On May 3, 2023, the State made the following changes to the Claims Filing Timeline for all the TP/PIHPs. This change supersedes Sandhills Center's April 1, 2023 announcement. The timely filing timeframe will be extended from 180 days to 365 days. The earliest effective date of this change will be July 1, 2023. The timely filing change will be required for all claims with service dates on and after July 1, 2023. This change directly impacts all Claims and Retroactive Enrollees' timely filing rules.
Jiva System to launch 4/1/2023 for all SAR Submissions
This is a reminder that Sandhills Center will be launching authorizations in Jiva on 4/1/2023. On March 22, 2023, all providers were sent a step-by-step guide for how to submit authorizations in Jiva for those who were unable to attend the training sessions provided on 2/17/2023, 2/24/2023, and 3/9/2023. We are also announcing a positive change in our authorization process, as the previous need to split authorizations between Alpha and Jiva will no longer be needed. Authorization requests will no longer be submitted in Alpha+ beginning 4/1/2023. At that time, all authorization requests -- regardless of date -- should be submitted through Jiva. Jiva is accessed by signing into Alpha+ and then clicking the green Jiva button at the top of the screen. Please submit an IT Ticket through the Provider Support Portal if you require any assistance. You may also contact the Provider Help Desk by phone at 1-855-777-4652, or send an email to ProviderHelpDesk@SandhillsCenter.org
ABOUT THE SANDHILLS CENTER PROVIDER NETWORK
Sandhills Center's Provider Network is dedicated to offering quality care for individuals residing in Anson, Davidson, Guilford, Harnett, Hoke, Lee, Montgomery, Moore, Randolph, Richmond and Rockingham counties. Our provider network assists Sandhills Center in fulfilling our mission to develop, manage and assure that persons in need have access to quality mental health, developmental disabilities and substance use services.
Each contracted provider is responsible for adhering to all policies and procedures outlined in the Provider Manual. Compliance is necessary to fulfill contractual obligations in providing services.
Find the searchable directory: Sandhills Center Provider Directory
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