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Behavioral Health Updates

Managed Care Organizations Updates as of 4/13/2022

PerformCare – Help Maintain PerformCare’s Online Provider Directory

PerformCare’s online provider directory helps PerformCare members find providers who are ready to care for their needs. Please help PerformCare make sure they have the most accurate information by reviewing the entries for your organization and its programs and sites in their online provider directory.

If any of the information — phone numbers, services, specialties, or languages — is incorrect, please email your Account Executive (AE) to request any changes or updates. If you are unsure who your assigned AE is, please reference the full county breakdown on PerformCare’s AE list (PDF). Thank you for helping PerformCare’s members find accurate information and avoid any barriers to care!

PerformCare – Now Available: Residential Treatment Facility (RTF) Provider Profiling Report

PerformCare’s Residential Treatment Facility (RTF) Provider Profiling Report Presentation (PDF) is now available online. The training provides information such as a review of the current provider profiling reports and an overview of the RTF report.

Access this and other trainings on PerformCare’s website.

PerformCare – Authorization Correction Process

PerformCare released notice AD 22 101: Authorization Correction Process (PDF) to provide additional clarification regarding the authorization correction process.

Following submission of an initial prior authorization or registration request, providers should review the authorization(s) in Jiva, or review the mailed paper copy of the authorization for accuracy. All errors should be reported to PerformCare for correction within 30 days of the date of approval. Requests for authorization corrections outside the 30-day period are subject to the administrative appeal process.

Access this notice and others on PerformCare’s website.

PerformCare – Recipient Language by County

PerformCare continues to focus on whole-person and person-centered care for our members. Important components of treatment include understanding and responding to cultural and language factors that affect our members’ ability to access and participate in behavioral health treatment.

To assist providers with understanding the demographics of our HealthChoices population, PerformCare is sharing membership data that includes the primary languages spoken by our members. Learn more about this in notice AD 22 102: Recipient Language by County (PDF) and our Member Language Summary (as of March 1, 2022) (PDF).

Access this information and other notices on PerformCare’s website.

PerformCare – New Intensive Behavioral Health Services (IBHS) Provider Choice Forms

PerformCare’s Intensive Behavioral Health Services (IBHS) page has updated versions of the following forms:

Visit our IBHS forms page to access more forms.

PerformCare – Co-Occurring Disorders Resources

Co-occurring disorders refers to when an individual has both a mental health diagnosis and a substance use diagnosis. Members with co-occurring disorders and co-occurring needs benefit from being offered a whole-person care approach and integrated treatment.

PerformCare shares the following resources to help you treat members with co-occurring disorders:

Access these and other resources on PerformCare’s website.

PerformCare – Resources for Preventing Substance Use in Children and Adolescents

Research supports the idea that children who have depression may be at a higher risk for using drugs or alcohol as they grow and develop.

PerformCare has added online resources to help with early identification of substance use, provide tips for parents, and offer information on prevention programs.

Access these and other helpful clinical resources on PerformCare’s website.

Beacon Health Options of Pennsylvania – Beacon Health Options of Pennsylvania, in partnership with Southwest Behavioral Health Management and Armstrong-Indiana Behavioral Health and Developmental Services, have issued a Request for Proposals (RFP) for: Intensive Behavioral Health Services (IBHS):Group Services

Deadline for submissions is Noon, Friday, April 29, 2022. Please view the RFP in its entirety here:

IBHS: Group Services

Submissions: Email a completed copy of the signed RFP to: Please type the title of the RFP and your organization’s name in the subject line.

Beacon Health Options of Pennsylvania – Provider Alert #2.22.03: Temporarily Waiving the Timely Filing Requirement 

In order to ensure that providers are reimbursed for services delivered for dates of service 2021, Beacon Health Options of Pennsylvania is waiving the 90-day claims timely filing requirement.

The timely filing requirement will be waived for 60 days beginning April 1 through May 31, 2022. This means that any dates of service for 2021 that are unpaid can be billed during this 60-day window and they will not incur any timely filing penalty.

Please be aware that all other claim requirements (eligibility, authorizations, TPL, etc.) must be in place before the claim is billed.

During 2021, many providers received COVID APA guarantee payments. To ensure continued funding to our communities in 2023 and beyond, providers are strongly encouraged to assure all eligible claims are billed to support the services delivered.

If you have any questions regarding this communication, please feel free to contact the Provider Services Line at 1-877-615-8503.

The Provider Alert may be retrieved here as a separate document for your records:

Beacon Health Options of Pennsylvania is Temporarily Waiving the Timely Filing Requirement

Beacon Health Options of Pennsylvania – Needs Your Ongoing Help to Gather Consumer Feedback

What are C/FSTs?

The Pennsylvania Department of Human Services (DHS) requires primary contractors to implement a comprehensive approach for measuring the satisfaction of HealthChoices Behavioral Health Consumers and Family members. This system includes Consumer/Family Satisfaction Teams (C/FST). C/FST members have face-to-face discussions with consumers/family members concerning, but not limited to, services received, access, delivery, outcomes, choice, treatment options, timeliness, and convenience of service delivery. The focus of the C/FST program is soliciting input and providing consumer information to the HealthChoices program in order to develop quality improvement actions. For the purpose of the HealthChoices program, C/FSTs are agents of the primary contractor and have the delegated authority to collect and disseminate the needed information. Providers are required to cooperate with the C/FSTs within confidentiality guidelines.

As a provider, you are interested in ensuring the consumers you serve are satisfied with your services and are achieving their treatment goals. Each county has a Consumer/Family Satisfaction Team. The teams are very active, primarily with larger providers. They are continually trying to reach more consumers. Beacon Health Options would like to remind all providers, particularly smaller providers and individual practitioners, to participate in the Consumer/Family Satisfaction Team process. You can do this by:

  • Reminding the consumers you serve about the Consumer/Family Satisfaction Teams. The phone numbers for the teams of each county are listed below.
  • Working with the Consumer/Family Satisfaction Teams when they contact you to identify consumers you serve who may be interested in completing a survey.
  • Providing Consumer/Family Satisfaction Teams with comfortable private space for interviews to ensure an environment in which behavioral health and/or substance abuse consumers and their families can feel free to express any concerns they may have.

Beacon Health Options and the Consumer/Family Satisfaction Teams would like to thank the providers who actively participate and would encourage providers who have not had the opportunity to participate to contact the team in your county for more information. 

C/FST Contact Information Per County:

  • Armstrong County (724) 548-1151
  • Beaver County  (724) 775-7650
  • Butler County (724) 283-5553
  • Crawford County (814) 336-2152
  • Fayette County (724) 438-6738
  • Indiana County (724) 548-1151
  • Lawrence County (724) 657-0226
  • Mercer County (724) 962-2778 or (724) 283-5553
  • Venango County (814) 676-5011 x106 or 1-800-611-6217 x106
  • Washington County (724) 225-9550 x405
  • Westmoreland County (724) 834-6351 or 1-800-871-4445 

Community Behavioral Health (CBH) – Provider Bulletin 22-07: ACT Value Based Payment (VBP) Case Rate Arrangement

This Bulletin is to alert Providers of the implementation of the ACT VBP arrangement (case rate) effective May 1, 2022. 

Please click here to view the full Bulletin.

Community Behavioral Health (CBH) – Provider Bulletin 22-08: Tobacco Use Disorder Treatment Reimbursement 

This Bulletin is to inform Providers of the opportunity to provide and bill for tobacco cessation services.

Please click here to view the full Bulletin.

Community Behavioral Health (CBH) – Update to American Society of Addition Medicine Value Based Payment Case Rate Arrangement

This Notice is to alert Providers of the claim adjudication process for American Society of Addition Medicine (ASAM) Value Based Payment (VBP.).

Please click here to view the full Notice.

Community Behavioral Health (CBH) – CBH News Blast Redesign

CBH News is getting a new look! The CBH Communications Department is updating the Provider news blast to give it a fresh, easy-to-read design.

Stay tuned for the redesigned version of CBH News in the coming weeks.

Community Behavioral Health (CBH) – CBH Tobacco Recovery Initiative Messaging

The CBH Tobacco Recovery Initiative seeks to address tobacco-related health disparities by ensuring that Philadelphians with behavioral health challenges have equitable access to evidence-based tobacco interventions. As part of the initiative, CBH encourages Providers to share the following snippet from the U.S. Department of Health and Human Services’ National Prevention Strategy report when appropriate:

“Research indicates that targeting tobacco use during substance use treatment can improve abstinence rates from both tobacco and substances of choice. In fact, combining treatments is the most effective way to address multiple co-occurring substance use disorders.”

For more information about the CBH Tobacco Recovery Initiative, please email Carol Larach, Director of Integrated Care Programs.

Community Behavioral Health (CBH) – Department of Drug and Alcohol Programs (DDAP) Information Bulletin 01-22: Reminder of Recovery House Licensure Requirements

The Pennsylvania Department of Drug and Alcohol Program (DDAP) issued the Information Bulletin 01-22 to remind all recovery houses in Pennsylvania, as well

as entities who refer individuals to recovery houses, of several requirements of the recovery house law (Act 59 of 2017).

Please click here to view the Bulletin.

Community Behavioral Health (CBH) – Department of Human Services (DHS) Encourages Pennsylvanians Receiving Benefits To Update Contact Information

Department of Human Services (DHS) issued a press release encouraging Pennsylvanians enrolled in Medical Assistance to make sure their contact information is up-to-date and sign up for alerts through the myCOMPASS PA mobile app.

Please click here to view the press release.

Community Behavioral Health (CBH) – Reminder of Department of Behavioral Health and Intellectual Disability Services (DBHIDS) Language Access Requirements

CBH is resharing DBHIDS’ memo from April 2021, Language Access Procedure for Providers, as a reminder for Providers about language access requirements when providing services to individuals who have Limited English Proficiency (LEP) and/or who are Deaf or Hard of Hearing (DFHH).

Please click here to view the memo.

Community Behavioral Health (CBH) – CBH News Blast Redesign

CBH News is getting a new look! The CBH Communications Department is updating the Provider news blast to give it a fresh, easy-to-read design.

Stay tuned for the redesigned version of CBH News in the coming weeks.

Community Behavioral Health (CBH) – Provider Notice: Reminder: 2022 CBH Personnel Roster Template

This Notice is to remind Providers about completing the CBH Personnel Roster.

Please click here to view the full Notice.

Community Behavioral Health (CBH) – CBH Provider Portal: Request for Provider Testing

CBH is preparing to launch the first iteration of a new Provider Portal in June 2022! To ensure that the Portal meets all of our Providers’ needs, CBH would like to invite Providers to participate in testing of the new portal taking place throughout the month of May.

Please click here to sign up for the testing.

If you have any questions, please email Molly Sadowsky.

Community Behavioral Health (CBH) – Diversity, Equity, and Inclusion Training Services Request For Proposal (RFP): Q&A

CBH has released the Diversity, Equity, and Inclusion Training Services RFP Q&A.

Click here to view the Q&A.

Community Care Behavioral Health (CCBH) – Provider Alert # 8
Updates from the PA Department of Human Services (DHS) Regarding Continuance of Suspended Regulations, Bulletins and Other Guidance, Due to the COVID-19 Pandemic, Effective 04/01/22

This Provider Alert applies to all HealthChoices contracted providers including agencies, independent
practitioners, and group practices. Please see Provider Alert #8 for more detail.

Magellan – Provider Notice: Regulatory Suspensions Extended

Magellan wants to ensure that our provider network is informed about the most recent
legislative action regarding waived and suspended regulations. See this Provider Notice for more detail.