Post on 14-Aug-2020
transcript
Eastpointe November 15, 201710:00am until 1:00pmWebinar
Welcome and Overview Linda Hawley Isbell
Eastpointe Provider Network Council English Albertson
Eastpointe Consumer and Family Linda Hawley Isbell
Advisory Committee
External Operations Updates Linda Hawley Isbell
Recover Concepts Community Center Gina Lane, LCAS, CCS
Revised Taxonomy List and Reminders Mark Lloyd
Utilization Management Updates Angela English
TCLI Supportive Housing Program Mackenzie Smith
Transition Team Henry Harris
NCTRACKS Melanie Weatherford
Single Case Agreement Reminders Yvonne Joyner
Chauncey Dameron
Insurance Reminders Mark Lloyd
Adding or Moving a Site Updates Chauncey Dameron
Henry Harris
Network Operations Updates Linda Hawley Isbell
Listserve
Next Provider Meeting
Contact Information
English Albertson
For Council Information: Go to www.eastpointe.net, then Provider then Provider Council.
Contact Information: providercouncil@eastpointe.net
The Eastpointe Provider Network Council meets the 4th Wednesday of the month (except November and December)
They meet at Skill Creations, 2105 Royal Avenue, Goldsboro, NC Upstairs Conference Room
The Provider Council is planning to outreach to all providers in our network to introduce themselves and provide some information.
Linda Hawley Isbell
CFAC has vacancies for Consumers or Family Members of consumers for the following counties:
Edgecombe
Sampson
Scotland
If you have a member or their family member who is interested in serving on CFAC please contact Melissa Reese at mreese@eastpointe.net or (252)407-2469.
Linda Hawley Isbell
Our Provider Network is closed.
Except for sites/services in which Eastpointe determines a current service need.
This is effective for Medicaid and State Services.
We are not currently adding new state contracts for the 2017/2018 Fiscal year.
We are not adding agencies or contracts for Licensed Independent Practitioners who have their own practice.
We are accepting applications for the following service needs:
Psychiatrist in private practice who provide Medicaid services.
Hospitals
Licensed Independent Practitioner applications from agencies who need to add an Outpatient Therapist.
Agencies may submit a request to add a site to provide Outpatient Services.
Agencies may submit a request to Subcontract to add a Therapeutic Foster Home or Unlicensed AFL only if an Eastpointe member will be placed in the home.
Eastpointe offices will be closed on November 23, 2017 and November 24, 2017.
Our Member Call Center will remain open as it is open 24 hours a day, even on holidays.
The RFI has been posted on our website and sent out on Listserve on November 13, 2017.
The start date is January 1, 2018.
The proposal must be delivered by hand or via certified mail on or before 12:00 PM EST on December 1, 2017.
Please refer the RFI for specifics about the submission of the RFI.
Please refer to the RFI as to how questions need to be submitted
The Eastpointe Area Board unanimously approved a consolidation agreement with Cardinal Innovations Healthcare. Both organizations are committed to improving the health and well-being of special populations in North Carolina.
The next step is for regulatory approval by the Secretary of DHHS.
We encourage you to keep up to date on consolidation efforts by:
Attending monthly Provider Meetings
Reviewing Eastpointe Communication Bulletins
Reviewing list serve announcements
If you are not already signed up for our Listserve we encourage you to sign up immediately. Please make note of the changes to this process that will be discussed later in the meeting.
Keep your information up to date on our Provider Directory.
A site or site location is an office at or from which:
Behavioral health services are provided
Records are stored
Billing is maintained
Supervision occurs
All sites must be approved by Eastpointe
A site cannot be a private home unless the agency is only providing residential services.
Examples
A site cannot provide other services that are not regulated by Eastpointe.
Adding/Updating a Taxonomy Code
Mark Lloyd
Submit Letter via email:
➢ Letter should be typed on Agency
Letterhead
➢ Letter should include appropriate Date
➢ Letter should include appropriate Signature
& Position
➢ Please ensure that information matches
NC Tracks- if not, include statement to
update NC Tracks
When updating clinicians’ taxonomy- include an agency grid sheet with the letter.
Letter should include:
✓ The agency name
✓ The date of the request
✓ The site name
✓ The site number (found in Alpha under Sites Tile and also
under the Site Tab)
✓ The NPI number
✓ The taxonomy code to update
✓ The reason for the request
✓ The effective start date
✓ The Certificate of Insurance (COI - General, Professional,
Auto Liability and Workers’ Compensation).
Please submit all Requests via email to
networkoperations@eastpointe.net with a
subject line: Taxonomy Code– Agency Name
Taxonomy Code Update
Communication Bulletin #52 – 10/26/17
Eastpointe has updated the Accepted Taxonomy List
To access:
www.eastpointe.net
Provider
Contracting and Payment for Services
Submitting Claims
Other Claims Information
Accepted Taxonomies for Behavioral Health
Services
Download Excel Spreadsheet
Questions
Please submit any questions in writing to
networkoperations@eastpointe.net with
a subject line: Taxonomy ???
Contact Information:
Mark Lloyd at 1-888-977-2160
Network Operations:
networkoperations@eastpointe.net
Charles LaCavera, UM Manager, LCAS, LPCS, MS, CRC, CCJP, CCS
clacavera@eastpointe.net
Claire Edwards, UM Manager, LPCcedwards@eastpointe.net
Iris Carter, UM Support Managericarter@eastpointe.net
Jessica Leal, Administrative Assistantjleal@eastpointe.net Contact for personal appointments with UM Director and/or managers.
If your agency has concerns or questions about Adverse Benefit Determinations and need additional information please contact Network Operations @ 1-888-977- 2160.
If you would like to request technical assistance from the UM Department please contact Jessica Leal, UM Administrative Assistance @ jleal@eastpointe.net or call 910-298-7046 to schedule a meeting.
If your agency is requesting a true Retrospective Request due to Medicaid eligibility please click the retrospective review button when completing the Service Authorization Request. (SAR)
ADVP Services- When submitting concurrent request please ensure you have included the member’s progress. This will help justify the reason for the request.
IPRS Residential ServicesInitial-SAR, Complete PCP with signatures, Evidence of DD before age 22 or TBI, NC SNAP; Concurrent- SAR, new request if requesting additional units, Complete PCP with signatures, additional information as applicable, NC SNAP;
All continued stay requests for residential services need to include a specific and detailed transition/discharge plan.
Community Guide services provide support to beneficiaries and planning teams that assist beneficiaries in developing social networks and connections within local communities.
(b)(3)- Waiver Service
T2041 U4 – Community Guide
Individual Support is a “hands-on” service for persons with Serious and Persistent Mental Illness (SPMI). The intent of the service is to teach and assist individuals in carrying out Instrumental Activities of Daily Living (IADLs), such as preparing meals, managing medicines, grocery shopping and managing money, so they can live independently in the community.
The goal is that the need for this service will fade or decrease over time as the individual becomes capable of performing some of these activities more independently. Developmental Therapy- Max four (4) months for the fiscal year. Four (4) per authorization
Individual Support (Personal Care) (b)(3) Waiver Service
T1019 U4 – Individual Support
One-time Transitional Costs (Community Transition) provide for one-time, set up expenses for adults to facilitate their transition from an institutional setting such as a State Developmental center, community ICF-IID, nursing facility, licensed group home, alternative family living, foster home, adult care homes (including those determined to be an Institution for Mental Disease), and State Psychiatric Institutions to a living arrangement where the individual is directly responsible for his or her own living expenses. This service may only be provided in a private home or apartment with a lease in the beneficiary’s / legal guardian’s / representative’s name or a home owned by the beneficiary.
T2038 U4 – ID/DD H0043 U4 – Mental Health
Peer Support services are structured and scheduled activities for adults age 18 and older with MH/SA disability. Peer Supports are provided by Peer Support Staff. Peer Support service is an individualized, recovery focused approach that promotes the development of wellness self-management, personal recovery, natural supports, coping skills, and self-advocacy skills and development of independent living skills for housing, employment and full community inclusion.H0038 U4 – Peer Support Individual H0038 HQ U4 – Peer Support Group
Physician Consultation services provide an avenue for communication between a primary care provider and a psychiatrist for a patient specific consultation that is medically necessary for the medical management of psychiatric conditions by the primary care provider.
Physician Consultation is provided at three different levels as follows: 99241 U4 – Physician Consultation, Brief
99242 U4 –Physician Consultation, Intermediate
99244U4 – Physician Consultation, Extensive
Respite services provide periodic support and relief to the primary caregiver(s) from the responsibility and stress of caring for children ages three (3) to twenty-one (21) with mental health, developmental disabilities or substance use/addiction service needs, and for adults 21 and over with developmental disabilities.
H0045 U4 –Individual Respite
H0045 HQ U4 – Group Respite
Supported Employment (SE) Services provide assistance with choosing, acquiring, and maintaining employment for individuals ages 16 and older for whom competitive employment has not been achieved and / or has been interrupted or intermittent.
The primary outcome of SE is competitive employment which is defined as a job that pays at least minimum wage, for which anyone can apply, and is not specifically set aside for people with disabilities. SE services must be provided in integrated work settings where the individual works alongside people who do not have disabilities or in a business owned by the individual.
Initial SE services include the following: Pre-job training / education
Vocational assessment
Career / educational counseling
Job shadowing
Assistance in the use of education resources
Resume development training
Job interview skills training
Assistance in learning skills necessary for job retention
Monitoring, supervision, assistance in job tasks, work adjustment training and counseling as needed to complete job training
Supported Employment (Employment Specialist)
(b)(3) Waiver Service
H2023 U4 - Individual Supported Employment
H2026 U4 – Individual Supported Employment Maintenance (LTVS)
H2026 HQ U4 – Group Supported Employment Maintenance (LTVS – IDD Only)
Medicaid Clinical Decision Support Tools for Behavioral Health
http://www.ncdhhs.gov/dma/mp/index.htm
EPSDT Informationhttp://www.ncdhhs.gov/dma/epsdt/index.htm
IPRS Clinical Decision Support Toolshttp://www.ncdhhs.gov/mhddsas/providers/servicedefs/index.htm
Records and Documentation Manualhttp://www.ncdhhs.gov/providers/provider-info/mental-health/records-management
Network Operations Call Center:
1-888-977-2160Network Operations Call Center staff will forward question to the appropriate UM staff to assist if additional information needed
Angela English, UM Director
aenglish@eastpointe.net
910-298-7011
Requesting a peer to peer
1-888-977-2160
Requesting a copy of the clinical rationale
1-800-513-4002 option 3
Mackenzie Smith, Lead Transition Coordinator
Voluntary settlement with the DOJ to remove individuals across the state from institutions to supported independent living
Settlement Terms:Move 3000 people across the state from ACH/State Hospitals into the community by 2020
Increase the number of ACTT providers at Fidelity Service Level
Increase the number of Supported Employment Providers at Fidelity Level
TCLI: Transition To Community Living Initiative
ACH: Adult Care Home/Domiciliary Living; Includes “traditional retirement homes” and Family Care Homes (FCH)
5600s: Mental Health Group Homes; not included as qualifying populations since MHGHs are meant to be therapeutic in nature
TMS: Transition Management Services; Required service for participation in TCLI if the person is not receiving ACTT Services
On the InReach List (aka THE List); sent to MCOs by DHHS identifying potential candidates in ACHs based on billed services
On the State Hospital InReach List: Sent by DHHS for all members both in the hospital or recently discharged that are eligible for the program
Direct referral from State Hospital
PASRR (aka Diversion): Authorization request for ACH Placement; If Level 2 screener determines the member has a severe and persistent Mental Illness and education regarding housing options are provided, the member will be referred to the MCO for either 90 day follow up or to begin the transition process.
Eligibility CriteriaMember’s wanting to participate in the TCLI Supportive Housing Program must meet the following criteria:
Must have a Severe and/or Persistent Mental Health Diagnosis that is the primary factor in the member’s inability to remain in the community, AND
Presently residing in any facility that is licensed as an Adult Care Home (ACH) (including Family Care Homes), OR
Referred from a State Psychiatric Hospital, OR
A PASRR has been completed to request ACH entry (Eastpointe must have received this authorization request from DHHS before member can be InReached)
Referral PathwaysReferred from a State Psychiatric Hospital
A PASRR has been completed to request ACH entry (Eastpointe must have received this authorization request from DHHS before member can be InReached)
Online referral: To make referrals to the TCLI Supportive Housing Program, please click the Online TCLI Housing Referral Form on Eastpointe’s website https://fd10.formdesk.com/eastpointe/TCLI_Care_Coordination_Referral
Member is identified via PASRR or InReach
Transition Clinician completes assessment and makes recommendations
for services
Case is assigned to a Transition Coordinator (TC) based on area the member
wishes to live
TC begins the workbook and refers the member to recommended services if
not already connected
Workbook is provided to the provider to be used as
a reference for the PCP
PCP, CCA, and Transition Workbook are sent to
DHHS for Final Approval of Housing Slot
Transition Staff assist the member in identifying and
applying for appropriate housing
Upon approval of the application for the
apartment, an inspection is completed if one has not be done in the past year
MOVE IN! Eastpointe will follow the member for 90
days post transition to insure the member is
stable
Comes with a small budget of funds to cover basic needs (furniture, home goods, etc), utility deposits, etc.
While TCLI Rental Vouchers are exclusive to TCLI participants, TCLI participants may utilize other Subsidy Programs (Section 8, Targeted Housing)
Participants are still allowed to use the TYSR funds if using a Section 8 voucher or a Targeted Unit
1 bedroom apartments are preferred for a single person
A waiver can be submitted if a one bedroom is unavailable in the member’s desired location (2 bedroom only)
Commonly referred to as TYSR
Up to $2000.00 is budgeted to assist the member in transitioning
Expires 1 year after requested
Allowed Expenses:Utility Deposits
Appliances (Refrigerators, Washer/Dryer (With Clinical Justification and only if a laundry mat is not within reasonable walking distance)
Furniture (Bed, Couch, Table, Chair, Dresser, etc.)
Home Goods (Linens, Cookware, Silverware, Dishes)
Electronics (TV (up to $150), small radio, toaster, coffee maker, microwave (with clinical justification)
SA-IH is a program for all county residents that require domiciliary care but could remain in the home with proper supports
Applied for at Local DSS office but regular residents have a waiting list
TCLI is a special priority population and does not have to wait for approval
Initially applied for by Transition Staff but recertification is the responsibility of the member and provider
Max limit is $1280 total income assets; SA-IH pays the difference from disability income, food assistance, etc. and the cost of expenses.
If member discontinues participation with TCLI, the member will lose his SA-IH and will be placed on the standard waiting list.
Similar in function as SA-IH
Offered to those who surpass the cut off for SA-IH but still require financial assistance
Can be used as a primary income if the member is waiting for disability benefits to kick in or has no other form of income
Both, SA-IH and CLA funds are limited to specific uses (if either are suspected to be used to fund anything other than Health and Safety needs the MCO and DSS need to be notified immediately)
Financial Recertification for SA-IH should be completed annually (requires an updated FL2); Contact will be made via Transition Staff or Local DSS
Units are inspected annuallyIndividuals moved prior to 1/3/17 should still be contacted by HFA with a copy of the letter mailed to the member regarding the scheduled date of the inspection
ACTT Services
Supported Employment
Transition Management Services-Required for TCLI participation unless receiving ACTT Services;
Not a clinical service and cannot be clinical home;
Allowed in conjunction with OPT, Med Management, CST, SE and PSR
Contracted by RHA (all 12 counties) and Stephen’s Outreach (Lumberton area only)
Providers are always the first point of contact in a crisis event.
Providers should then contact the Transition Coordinator to assist in mitigating the crisis
Critical Time Intervention – Offered in Wayne and Wilson Counties
Crisis Examples (not exhaustive):Eviction
Hospitalization
Being victimized or involved in criminal activity resulting in legal action
Increase in Substance Use upon placement
Member discontinues services
For questions, comments or additional information, pleasecontact:
Diane Hagar, 252-520-8847
TCLI Admin Assistant
Sandra Pope, 252-298-7029
TCLI Admin Assistant
Mackenzie Smith, 252-520-8876
TCLI Lead Coordinator
Tom Miller 252-520-8869
TCLI/Housing Director
Lynnette Gordon, 910-298-7036
Assistant Clinical Officer
Information and eligibility requirements regarding TCLI can be found on Eastpointe’s website at: http://www.eastpointe.net/members-and-families/housing/#1508360426702-5eb03062-dad7
Eastpointe Presenter: Henry Harris
Purpose
Eastpointe Staff Members
Meeting
Type of Letters
Caseload Form
Medical Records Storage Form
Miscellaneous
To assist providers and members with issues pertaining to moving sites, closures, termination of services and suspensions. (If any of these pertain to the situation the Provider will receive a letter from the Transition Team and any members served in the last 6 months will receive a letter)
Members- Henry Harris and Veronica Murphy are co-chairs with numerous staff from the various departments of Eastpointe
Meets at least once a month and more if deemed necessary
Contract ending Letters
Provider moving letters
Cease and Desist Letters
Suspension of Payment Letters (DMA)
Discontinuation of Services Letter
Member Letters- (Child & Adult)
Letters to providers sent registered mail
Letters to members sent regular mail
2ND Request letters
Where to find form- www.eastpointe.net> Provider> Manuals and Forms > Forms > Electronic Forms > Initial/Final Caseload Form. It is a form desk so once you submit we will have it
If there are a large amount to transition ie 75 or more you can put on a spreadsheet and send in to Eastpointe via email networkoperations@eastpointe.net or fax 252-407-2450
Where to find form- www.eastpointe.net> Provider > Manuals and Forms > Forms > Electronic Forms > Medical Record Disposition Form
It is a form desk so once you submit we will have it
Please follow instructions in the letter
Providers are supposed to let Eastpointe know if they are closing or terminating a service in writing on company letterhead signed by CEO or designee
Providers moving a site will inform Eastpointe via add/move a site form located www.eastpointe.net > Provider > Manuals and Forms > Forms > Electronic Forms > Add/Move Site
Eastpointe per contract is supposed to get 60 days notice for IDD and 30 days notice for MH/SA
Website: www.eastpointe.net
Network Operations Call Center:
888-977-2160
Email: networkoperations@eastpointe.net
Fax: 252-407-2450
Member Call Center 800-913-6109
Fax: (910) 298-7186
Melanie Weatherford
Eastpointe can upload changes to NC TRACKS to add NPI, Taxonomy codes, and sites and the turn around for this submission is 24-48 hours if a Managed Change Request is not currently under review.
Please send the following information in writing on Agency Letterhead to networkoperations@eastpointe.net
Name of Agency- (name shown in NC TRACKS)
Date of Request
The letter needs to be signed and dated by the NC TRACKS Office Administrator (this must be identified and it is required that we have approval before we can proceed with uploading changes to NC TRACKS)
Email address
NPI
Tax ID
Effective Date
Site address
Zip plus 4
County
Phone number
Taxonomy
Licensure type if applicable ( for Licensed clinicians)
License number if applicable (for Licensed clinicians)
Effective and end date If licensure is applicable (for Licensed clinicians)
Provider Bed Type if applicable- (this applies to Residential Services)
# of beds if applicable (applies to residential services)
If you are experiencing issues with NC TRACKS such as delayed processing time with a Manage Change Request (MCR) please email networkoperations@eastpointe.netPlease include the following information in the email so we can better assist you.
• Name of Agency or LIP with TAX ID
• NPI
• Date the Manage Change Request was submitted to NC TRACKS
• MCR ID Number (reference number) top left side of the NC TRACKS Provider Enrollment Form
• MCR Description ( provider enrollment, add address, add taxonomy)
• Please indicate the status ( in review, approved, denied, unable to submit)
Please be sure to print your manage change request for your records before you submit.
It is important that we have the date the MCR was submitted to NC TRACKS and the MCR reference number so we can better assist our providers.
This information is submitted to the state to help with escalation but we are unable to help without the required information.
NC TRACKS
Document Viewer
SINGLE CASE AGREEMENT(SCA)
Yvonne Joyner, QP, BS
Provider Relations Specialist
Network Operations
Chauncey Dameron, MBA
Provider Relations Specialist
Network Operations
•May be requested by both in and out of network providers.•Is requested when a member needs a specific Medicaid or state funded service for a specific period of time and there is not a provider in the network available to provide the needed service.
• The SCA application is used to request both Medicaid and IPRS funded services.
• All questions on the application must be answered.
• Only one member per application.
• Multiple services can be requested on the same application. Both the service and service code must be provided.
• Funding Source: Is the requested service Medicaid or IPRS Funded?
Date: actual date the application is submitted or resubmitted to Eastpointe.
Provider information on the application should be the same as the provider information in NC Tracks or the application will be determined Unable to Process (UTP).
Required attachments (Section 10) must be submitted along with SCA.
Zip codes require both the zip code and the plus 4 when requested.
Medical necessity must be determined for services requiring pre-authorization before the SCA can be approved.
Members should not be placed or receive services until the Single Case Agreement is approved.
Providers can not receive payment for services until the SCA is approved and set up in Alpha.
• Application is available in two formats: printable and web submission.• Downloadable format www.eastpointe.net→ Provider →Manuals and Forms →Forms → Single Case Agreement .
• This format should be submitted via fax to 252-407-2450 or via secure email to networkoperations@eastpointe.net.
• Electronic submission format: www.eastpointe.net→ Provider →Manuals and Forms → Electronic Forms → Single Case Agreement .
• The required documents listed under Attachment B should be included when submitting the SCA regardless of the format.
• These documents are available on the Eastpointe website at www.eastpointe.net→ Provider →Manuals and Forms → Forms.
• You should be able to save them to your desktop and once complete, they can be attached to both the Downloadable and/or Electronic Form.
⚫ they can be attached to the formdesk form.
⚫ them to your desktop and once complete, they can be attached to the formdesk form.
Certificate of Insurance (COI) must be current. Insurance requirements are listed on the SCA under #5 of the agreement details.
All applications, including resubmissions, require an original signature and current signature date.
Incomplete and backdated applications cannot be processed.
Providers are notified via secure email and certified letters of unable to process requests.
Questions regarding the SCA, review process, Unable to Process notification, etc., will be addressed by Network Operations.
Contact can be made via telephone at 888-977-2160 or by sending a secure email to networkoperations@eastpointe.net
Mark Lloyd
Professional Liability:
✓Required for all contracts
✓$1 million each occurrence (or claims made)
✓$3 million general aggregate
General Liability:
✓Required for all contracts
✓$1 million each occurrence (or claims made)
✓$3 million general aggregate
✓General Liability is not the same as
Business Liability or Premises Coverage.
Workers Compensation
✓Each accident- $100,000
✓Disease for each employee- $100,000
✓Policy Limit- $500,000
✓Required for 3 or more employees
✓http:///www.ic.nc.gov/employers.html
Remember to submit
at least seven days
prior to expiration
Questions
Please submit COI via email to mlloyd@eastpointe.net or networkoperations@eastpointe.net with a subject line: COI – Agency Name
Contact Information:
Mark Lloyd at 1-888-977-2160 or
mlloyd@eastpointe.net
Network Operations:
networkoperations@eastpointe.net
Network Operations- Insurance; 500 Nash
Medical Arts Mall; Rocky Mount, NC 27804
Chauncey Dameron, MBA
Eastpointe Local Management Entity /Managed Care Organization’s (LME/MCO) providers must receive written prior approval from Eastpointe before moving a current Contracted site to a new location or adding a site to their current contract.
This process occurs when a provider is approved to add a site to their current contract
Eastpointe currently has a closed Provider Network, but has approved for providers to request to add an Outpatient Therapy Site ONLY
This process occurs when a provider is approved to move a site that is part of their currentcontract from one location to another location.
In order to streamline the process, Eastpointe has developed an Add/Move a Site Location web submission form that will be submitted automatically to Network Operations.
The Web Submission form will replace providers submitting a request on their agency’s letterhead to add/move a site location.
Eastpointe started the use of the Add/Move a site location web submission form on February 1, 2017. (Written letters are no longer accepted.)
Provider must submit the request to Add/Move Site Location via the web submission form.
The form is located at www.eastpointe.net > Provider > Information, Manuals, and Forms >Electronic Forms> Add/Move Provider Site Form
After the Add/Move Site form has been received and deemed correct. A “Good Standing” review will be conducted internally by Eastpointe staff for both types of requests.
If a provider is found to be in “Good Standing” then the request will be forwarded to Provider Monitoring department for an Onsite Review.
If the provider is determined to be “Not in Good Standing” then the process will cease and a letter will be sent to the provider notifying them that they have not been approved to add or move a site.
Once the onsite review has been completed, the provider will receive an Approval letter including an Attestation Statement from Network Operations via DocuSign notifying them that the site has been approved.
If the provider is Adding a new site, the provider will need to complete the Attestation Statement to indicate the effective date of providing services at the new site. (Date must be on or after the effective date indicated on approval letter)
If the provider is Moving to a new site, the provider will need to complete the Attestation Statement to indicate the effective date of closure for the current site and the effective date of providing services at the new site.
If there are 20 or less authorizations that need to be transferred to the new site, please submit new SARs within the approved timeframe on previous SAR authorizations.
If there are 21 or more current authorizations that need to be transferred to the new site, please submit the Authorization Request Transfer Form and also submit new SARs within the approved timeframe on previous SAR authorizations.
The Authorization Transfer Form can be located on our website www.eastpointe.net. Go to Provider > Information, Manuals, and Forms > Authorization Transfer Form.
The form must be submitted to Network Operations via email networkoperations@eastpointe.net or fax 252-407-2450
Moving to a new site location without approval can affect members dramatically. A member may go to the site location for services and the site location has been moved without the MCO Call Center knowledge.
The member can go into a crisis situation while trying to seek out services.
Linda Hawley Isbell
A new Agency Grid Sheet was posted on our website with an effective date of October 26, 2017. As of that date we will not accept any older versions of the Grid Sheet.
The person who completes the Grid Sheet will be attesting that the Licensed Staff listed on the Grid Sheet are all covered under your agencies insurance for the required insurance as stated in our Provider Contract Manual.
This form must be submitted with each Credentialing and Re-Credentialing application.
Earlier this year we changed our process to send out reminder letters to providers 90 days before their Credentialing would expire to remind them to submit a Re-Credentialing application.
We have continued to receive Re-Credentialing applications shortly before the Credentialing end date.
We will now begin sending reminder letters both 90 days before expiration and again 60 days before expiration.
Directions for signing up for list serve:
1. Go to Eastpointe’s website at http://www.eastpointe.net
2. Click on Provider
3. Then click on Manuals and Forms
4. Then click on Listserve Announcements
5. Go to: Sign up to join the Eastpointe Listserve!
6. Enter your email address (make sure you type it correctly), enter your first
and last name, and agency
7. Click on the Sign Up button
8. After you sign up, a Thank you page will open. You have been added to the
mailing list and can exit
You will receive an email that your request has been submitted
Please remember to register for Provider Meetings on our website
Under Provider Community
Then Calendar of Events
Our next meeting is scheduled for December13, 2017 from 10:00am until 1:00pm and this will be a webinar.
Please contact Network Operations Call Center at
(888) 977-2160 or
networkoperations@eastpointe.net
Fax: 252-407-2450
Member Call Center 800-913-6109
Fax: (910) 345-8971
Visit our website www.eastpointe.net to locateCommunication Bulletins
Manuals
Provider Meeting PowerPoint’s
Provider Forms
Training Announcements and Sign Up
Provider Directory
And so much more