Behavioral Health Updates
Managed Care Organization updates – 9/15/2021
Community Behavioral Health (CBH) – Provider Bulletin 21-12: Access to Timely Treatment (Amended)
This Bulletin is being issued as an addendum to Bulletin 20-14.
The addendum to this Bulletin is being issued to highlight the following: CBH has developed a form for providers to utilize as a mechanism for submitting written notice to their assigned CBH Provider Relations Representative. The form will collect information about service locations affected, effective and target date, person responsible for monitoring the plan, and will also allow for an upload of the required supporting documentation on official company letterhead which must include details around the barriers to access as well as the detailed plan for reconciling the barriers. This form is available for immediate use by the provider network; however, all Providers are expected to utilize this mechanism for notification, effective October 9, 2021.
Community Behavioral Health (CBH) – Provider Bulletin 21-11: Continuation of COVID-19 Alternative Payment Arrangement (APA)
This Bulletin serves as official notice of the continuation of the COVID-19 Alternative Payment Arrangement (APA) through December 31, 2021.
Previously, all providers were required to shift back to a fee-for-service (FFS)/claims-based payment system as of October 1, 2021. CBH is committed to ongoing partnerships with the provider community and continues to work in conjunction with the Department of Behavioral Health and Intellectual Disability Services (DBHIDS) and the Pennsylvania Department of Human Services (PA DHS) Office of Mental Health and Substance Abuse Services (OMHSAS). These partnerships have resulted in the approval to extend the COVID-19 APA through the end of calendar year 2021 (December 31, 2021) for all providers wishing to continue operating under this funding mechanism.
Community Behavioral Health (CBH) – Provider Bulletin 21-10: Utilization and Retrospective Review
Previous Bulletins were issued on April 13, May 18, and June 10, 2020, detailing a temporary suspension of utilization review to align with a mandate from The Department of Human Services, Office of Mental Health and Substance Abuse Services (OMHSAS) Pennsylvania Office.
This Bulletin, effective October 1, 2021, serves as a comprehensive overview of our return to utilization review and a phased approach for implementing retrospective reviews.
Community Behavioral Health (CBH) – IBHS Billing Questions
To develop written guidance, the CBH Compliance Department is asking for CBH Providers to submit any billing-related questions regarding Intensive Behavioral Health Services (IBHS). Questions may be regarding clarification of relevant regulations and billable vs. non-billable activities. Once all questions are compiled and answered, a Billing Guide will then be submitted to OMHSAS for approval and published to the CBH website. Questions may be submitted to Marie.Raupp@phila.gov with “IBHS Question” as the subject line. Please submit all questions by Friday, September 24, 2021.
Community Behavioral Health (CBH) – Information Sessions on Complaints and Grievances
CBH conducts an annual Provider Satisfaction Survey (PSS) to gauge performance and obtain provider feedback. The results of the PSS help CBH identify key opportunities for improving the experience of providers. Based on the feedback received from providers, CBH held several information sessions on the complaint and grievance process. The sessions not only reviewed the complaint and grievance process but the expectation of the provider. Those who were unable to attend the information sessions can view a recording of the Zoom. Please direct any questions to Kelley Berke, Manager of Complaints & Grievances, at 267-602-2215 or Kelley.Berke@phila.gov.
Click here to view the recording. Access Passcode: iR=5De3D.
Beacon Health Options of Pennsylvania COVID-19 Guidelines: Update at 18 Months – PROVIDER ALERT – Alert # 6.21.9
At Beacon Health Options strives to share the most up-to-date COVID-19 information to support our Provider Community in the delivery of valuable services to those we serve. While providers do not have to adopt any specific protocol, Beacon Health Options expects that providers will have policies that take adequate steps to protect their staff and the community. As with previous Beacon Health Options Pennsylvania COVID-19 Guidelines, this update is intended to present an aggregation of information from the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, academic institutions and other reliable sources. Please view the Provider Alert linked below. If you have any questions or concerns about these expectations, please contact your Provider Field Coordinator.
Beacon Health Options of Pennsylvania Updated Timely Filing Waiver Request Process – PROVIDER ALERT – Alert # 7.21.9
Beacon Health Options of Pennsylvania has updated the Timely Filing Waiver Request Process. These changes will make the process completely paperless and much more streamlined. Please read the Provider Alert issued below for details. The new process is in effect immediately.