Processes and Frequently Asked Questions for Alliance Health 1915(i) Services

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Benefit plan service detail can be found on the Alliance Health Non-Medicaid Benefit Plan Service Details webpage. Type 1915i in the search box and all Medicaid 1915i service definitions will populate.

Additional information is available on the Alliance 1915(i) Assessment Fact Sheet, including information on Prior Submission and ISP Timelines.

CMA/AMH+ providers receive resources related to 1915(i) processes and plan information via TCM distribution email addresses.  

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Practice Transformation has completed 5 1915(i) trainings for CMA/AMH+ providers.

All trainings are available via on demand through Alliance Health’s Learning Management system, KnowledgePoint.

Training slides, plan templates and links to the 1915(i) Independent Assessment, and Clinical Coverage Policies are also available in KnowledgePoint.

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The Alliance All Provider Meeting offers opportunities for providers to receive 1915(i) updates as well as ask questions.

Contracted providers may send questions to NetworkRelations@alliancehealthplan.org or to directly to their assigned Network Relations Specialist.
Providers have received 1915(i) updates via the All Provider Meeting and targeted emails to 1915(i) providers.

CMA/AMH+ providers - practice transformation provides 1915(i) services updates and opportunities for CMA/AMH+ providers to ask questions and share feedback during meeting consults, CMA and Supervisory Learning Collaboratives.

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Practice Transformation meets with CMA/AMH+providers weekly to monthly to discuss Members needing to transition from 1915(b)(3) to 1915(i) Services.

Practice Transformation addresses questions, concerns and/or workflows based upon feedback from each CMA/AMH+ provider.
Provider-led Entities’ Care Managers may direct questions to NetworkRelations@alliancehealthplan.org. 
 

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CMA/AMH+ providers may contact their assigned Practice Transformation Specialist and/or outreach Practice Transformation at PracticeTransformation@alliancehealthplan.org if they have questions on 1915(i).

Contracted providers may reach out to  NetworkRelations@alliancehealthplan.org.

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CMA/AMH+ providers should follow Alliance’s Health’s process and submit 1915(i) assessments to 1915isupports@alliancehealthplan.org.

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CMA/AMH+ providers may contact their assigned Practice Transformation Specialist and/or outreach Practice Transformation at PracticeTransformation@alliancehealthplan.org for updated status.

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CMA/AMH+ Care Managers can check NC HealthConnex, NCTracks and alert their assigned Practice Transformation Specialist if they are unable to locate member contact information.

After three unsuccessful attempts to include outreach to the (b)(3) Service Provider, CMA/AMH+Care Managers will alert their Practice Transformation Specialist.  
 

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CMA/AMH+ providers may contact their assigned Practice Transformation Specialist and/or outreach Practice Transformation at PracticeTransformation@alliancehealthplan.org if they have concerns locating Members.

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CMA/AMH+ providers receive an updated list of contracted 1915(i) providers monthly. The Site and Service spreadsheet is sent to each CMA/AMH+ provider’s TCM distribution email address.

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Alliance Health created an ISP/Care Plan template which meets 1915(i) ISP/Care Plan requirements.

CMA/AMH+ Care Managers can login into Alliance’s Learning Management System, KnowledgePoint, to access “Requesting 1915i Services after Eligibility Approval” to learn how to create the ISP/Care Plan.

Training on how to complete the ISP/Care Plan is embedded in the IPS-Supported Employment for MHSUD Members, 1915i for MHSUD Members and 1915i Requesting Services.
 

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CMA/AMH+ Care Managers can login into Alliance’s Learning Management System, KnowledgePoint to access training on submitting SARs/Prior Authorizations for 1915i Services.

The two trainings in KnowledgePoint are titled, JIVA UM Provider Portal for Jiva UM Provider Portal for CMA/AMH+ (non-JIVA users) and JIVA UM Provider Portal for CMA/AMH+ (JIVA users).

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CMA/AMH+ providers may contact their assigned Practice Transformation Specialist and/or outreach Practice Transformation at PracticeTransformation@alliancehealthplan.org if they have questions on 1915(i) service codes.

Care Managers may submit a Contract Request form if the Provider of Service does not have a 1915(i)-service code in their contract.

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CMA/AMH+ providers - care managers submit electronic prior authorization request for 1915(i) services.

Care managers can contact the Utilization Management Specialist if they have additional questions and/or modifications to their pending service authorization.

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1915(i) service providers may contact their Provider Relations Specialist to forward questions regarding member assignments.

CMA/AMH+ providers - 1915(i) service providers can contact Member and Recipient Services to look-up a member’s care manager. If the member is linked to a CMA/AMH+, 1915(i) service providers can contact PracticeTransformation@alliancehealthplan.org for CMA/AMH+ distribution contact information.