Provider HelpDesk
Questions and Answers for September 2015
Utilization Management / SAR / Do I have to submit a PCP for every re-authorization for SAIOP? / Yes. An updated PCP is required with every re-authorization for SAIOP services.Utilization Management / Other / What’s the age limit for Multisystemic Therapy (MST)? / Multisystemic Therapy (MST) is a program designed for youth generally between the ages 7 through 17 who:
a. have antisocial, aggressive or violent behaviors;
b. are at risk of out-of-home placement due to delinquency;
c. adjudicated youth returning from out-of-home placement;
d. chronic or violent juvenile offenders; or
e. youth with serious emotional disturbances or a substance use disorder and their families.
Utilization Management / SAR / What services cannot be provided during the same authorization as Intensive In-home (IIH)? / IIH services cannot be provided during the same authorization period as the following services:
a. Multisystemic Therapy;
b. Day Treatment;
c. individual, group and family therapy;
d. Substance Abuse Intensive Outpatient Program;
e. child residential treatment services Level II Program Type through Level IV;
f. Psychiatric Residential Treatment Facility (PRTF); or
g. substance abuse residential services.
ME&E / Discharge / Will the state insurance (IPRS) be end-dated if a full discharge is completed for a member? / Yes. When a member is fully discharged their state insurance will also be end-dated.
ME&E / Discharge / If a consumer passes away, do I need to complete a discharge? / Yes. A discharge form must be completed for the deceased.
ME&E / Discharge / How can I get the service code to populate on the discharge form? / You must use the numeric service code (ex. 90832, 90834, 90837) and the service description will populate.
Customer Service / Other / Who do I need to contact if a provider will not pay the clinicians for services provided? / The employee should contact the Department of Labor at 1-800-625-2267 or
Network / Credentialing / How can a provider add a service to an existing contract? / The Network is currently closed. SHC is not adding sites or services to existing contracts.
IT / Alpha / How can I get access to the AlphaMCS Portal? / Providers must complete the Alpha Provider Request Form. Contact the Provider Help Desk at 855-777-4652 or to receive the form.
Quality Management / Other / How often is the Post Payment review completed? / A Post Payment review is completed once every two years for all providers.
Finance / Billing / Where can I access the checkwrite schedule? / To access checkwrite schedule, go to click onFor Providers, then chooseProvider Forms. The checkwrite schedule will be located under the Finance, Billing and Claims category.
Network / Credentialing / Will providers receive a notice when it is time for re-credentialing? / Yes. Providers will receive a certified letter from the Network Director indicatingthe due date for submitting the re-credentialing applications. The assigned credentialing specialist will follow-up immediately after the letter is mailed.
Utilization Management / SAR / Can a SAR include more than one service code? / Yes. After completing the initial service request, select the “Add Service” tab to add additional services to the SAR.
ME&E / Discharge / Can providers print the discharge form in Alpha? / No. The discharge form is unable to print in AlphaMCS. However, providers have the ability to view all the discharge forms completed by selecting “All Discharge” in the Discharge tab.
ME&E / Enrollment / How can a provider complete an enrollment request for a member receiving Health Choice insurance? / Sandhills Center does not manage Health Choice. The provider can contact Value Options at 800-753-3224 for assistance.
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