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

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The Partners Provider Knowledge Base contains clinical tools including the current Benefit Grid and links to the 1915(i) Clinical Coverage Policies.

There is on-demand 1915(i) training available under Partners Training Resource and Collaborative related to the 1915(i) State Plan Amendment at the Accessing 1915(i) Services roadmap flyer.

ANSWER:

There is an on-demand 1915(i) training available on the Partners Training Resource and Collaborative webpage.

• For authorization questions providers can reach out to UM via Partners’ workgroup or by email at UMQuestions@partnersbhm.org
• For authorization related issues BH UM Workgroup: 704-842-6436
• For authorization related issues I/DD UM Workgroup: 704-884-2605

1915(i) service providers should contact their assigned provider account specialist or pas@partnersbhm.org for other questions.

TCM providers should contact their assigned clinical support specialist or tailoredcaremanagement@partnersbhm.org for other questions.

ANSWER:

Partners has no meeting or office hours specific to 1915(i) providers. Partners will address 1915(i) and any questions related to same in the following regularly scheduled provider meetings. Providers can contact Utilization Management or Provider Network team members with questions using the information below:

• For Authorization Issues providers can reach out to UM via Partners’ workgroup or by email at UMQuestions@partnersbhm.org 
• For authorization related issues BH UM Workgroup: 704-842-6436
• For Authorization related issues I/DD UM Workgroup: 704-884-2605

1915(i) service providers should contact their assigned provider account specialist or pas@partnersbhm.org for other questions.

ANSWER:

Partners hosts Biweekly TCM provider forums and monthly 1:1 meetings with each CMA/AMH+. TCM providers receive feedback/updates and can ask questions.

• For Authorization Issues TCM can reach out to UM via Partners’ workgroup or by email to UMQuestions@partnersbhm.org 
• For Authorization related issues BH UM Workgroup: 704-842-6436
• For Authorization related issues I/DD UM Workgroup: 704-884-2605

TCM providers should contact their assigned clinical support specialist or tailoredcaremanagement@partnersbhm.org for other questions.

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1915(i) providers should contact their assigned provider account specialist or pas@partnersbhm.org.

TCM providers should contact their assigned clinical support specialist or tailoredcaremanagement@partnersbhm.org.

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TCM Providers submit 1915(i) assessments directly to Carelon, following their internal agency protocols. A copy of the assessment submission should be sent to 1915i@partnersbhm.org.

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TCM providers are notified by Partners as eligibility approvals are received.

TCM providers can also reach out to their assigned Clinical Support Specialist or tailoredcaremanagement@partnersbhm.org for assistance identifying 1915(i) assessment status and eligibility approval.

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Care Managers should utilize all available options to obtain contact information for the member. In addition to contacting 1915(i) or 1915(b)(3) providers, care managers can use NCTracks, HIE, other service providers, etc.

If unable to obtain contact information, the care manager can contact the Care Connection team at Partners at (704) 842-6311 or ScreeningandReferral@partnersbhm.org to determine if there is any additional information available.

If a member cannot be reached the Partners Care Connection Team will take member onto an “unengaged” caseload and continue to make attempts to reach member at least annually moving forward. 

ANSWER:

If unable to obtain contact information, the care manager can contact the Care Connection team at Partners at (704) 842-6311 or ScreeningandReferral@partnersbhm.org to determine if there is any additional information available.

If a member cannot be reached the Partners Care Connection Team will take member onto an “unengaged” caseload and continue to make attempts to reach member at least annually moving forward.

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A list of contracted providers is available on the Partners Heath Management website - provider search function partnersbhm.org/provider-search/#.

Questions can also be directed to the TCM provider’s assigned clinical support specialist.

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Care Managers should consult with their supervisor for information on how to complete the Care Plan/ISP for someone using 1915(i) services.

Specific questions about utilization management requirements can be submitted to UMquestions@partnersbhm.org.

TCM providers can also contact their assigned clinical support specialist or tailoredcaremanagement@partnersbhm.org for other questions.

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Partners Training Resource and Collaborative has posted training and resources on how to submit a SAR in Partners’ ProAuth portal at the Partners’ Training Resource and Collaborative webpage.

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Partners Provider Knowledge Base contains clinical tools including the current Benefit Grid and links to the 1915(i) Clinical Coverage Policies.

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The care manager can see the status of a submitted Service Authorization Request in ProAuth.

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1915(i) service providers can monitor NCTracks for TCM provider agency. They can also contact Partners Care Connections Screening and Referral team at (704) 842-6311 or ScreeningandReferral@partnersbhm.org for assistance identifying the assigned TCM entity and/or care manager.