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

ANSWER:

TCM providers receive monthly education about Trillium’s process and steps needed to transition members from 1915(b)(3) to 1915(i). Trillium provides this information at their TCM Provider Forums and at their 1:1 meeting with TCM consultants.

Trillium publishes Network and Clinical Communication Bulletins (NCB and CCB) with updated information around 1915(i). See NCB 332, 333, 235 and CCB 16, 32, 40, 42, and 49.
NC Medicaid’s 1915(i) Provider Resource Frequently Asked Questions (FAQs) is the source of truth for trainings, codes and processes. Trillium has published this information in CCB 42 and 43 with all the resources on the Trillium Provider Communications webpage.

Trillium also has a TCM guide.

ANSWER:

TCM Providers are educated monthly about Trillium’s process and the steps needed to transition members from 1915(b)(3) to 1915(i). Trillium provides this information at their TCM Provider Forums and at their 1:1 meeting with TCM Consultants.

Trillium publishes Network and Clinical Communication Bulletins (NCB and CCB) with updated information around 1915(i). See NCB 332, 333, 235 and CCB 16, 32, 40, 42, 49.
Trillium has included the 1915(i) Provider Resource Frequently Asked Questions (FAQs) information from NC Medicaid in CCB 42 and 43, with all the resources. This is the source of truth for trainings, codes and processes published on the Trillium Provider Communications website.

Trillium also has a TCM guide.

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Providers can contact the PSSL at (855) 250-1539 or via email at NetworkServicesSupport@trilliumnc.org with any questions. The PSSL is open Monday through Saturday from 7 a.m.-6 p.m.

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Trillium has monthly TCM provider forums and 1:1 meeting with consultants.

Providers can contact the PSSL at (855) 250-1539 or via email at NetworkServicesSupport@trilliumnc.org with any questions. The PSSL is open Monday through Saturday from 7 a.m.-6 p.m.

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Providers should email UM@trilliumnc.org for questions related to 1915(i) services.

For questions related to contracting, providers should email networkservicessupport@trilliumnc.org 

Providers can contact the PSSL at (855) 250-1539 or via email at NetworkServicesSupport@trilliumnc.org with any questions. The PSSL is open Monday through Saturday from 7 a.m.-6 p.m.

Providers may submit 1915(i) questions using the Smartsheet Submission Form: 1915(i) Questions SmartSheet Form

ANSWER:

CCB 42 and 43 – NC Medicaid’s 1915(i) Provider Resource Frequently Asked Questions (FAQs) webpage includes information on where to submit the 1915i assessments.
The TCM or care coordinator submits 1915(i) assessments directly to Carelon at NCMedicaid1915irequests@carelon.com

Please include the information below in the email:

• Provider or MCO contact’s first and last name
• Contact’s direct email address and phone number
• Beneficiary’s name and MID (as listed on the assessment)

TCM will receive feedback directly from Carelon after submitting the completed assessment directly to Carelon.

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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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Providers can reach out to their TCM consultant by phone or email if they have difficulty finding contact information for members so their TCM consultant can look in Trillium’s records and NCTracks to see if there is additional contact information.

Trillium has informed their TCM providers if they have difficulty engaging with any 1915(i)service providers, they should let their TCM consultant know so Trillium can intervene if necessary.

ANSWER:

TCM Providers may reach out to their TCM consultant by phone or email if they have difficulty finding contact information for members so their TCM consultant can look in Trillium’s records and NCTracks to see if there is additional contact information.

We have informed Trillium’s TCM providers if they have difficulty engaging with any 1915(i) service providers, they should let their TCM consultant know so we can intervene if necessary.

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Trillium Plan-based Care Managers can search Trillium’s provider data management system to view contract level data for each provider as well as view the Provider Directory.

Trillium network staff send a list of all contracted providers to Trillium’s TCM providers, which can be sorted by service code and county.

TCM Provider-based Care Managers can also reference Trillium’s Provider Directory.

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NC Medicaid’s 1915(i) Provider Resource Frequently Asked Questions (FAQs) webpage includes information about how to complete care plan. (CCB 42 and 43.)

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Trillium’s My Learning Campus Providers portal has trainings on TAR submission for all services.

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Clinical Communications Bulletins (CCB) include information about clinical and coding updates. For 1915i see CCB #42 and 43 on the Trillium Provider Communications webpage.

Also see the Benefit Plan webpage for all codes.

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Provider Direct includes information on what services a member has authorized at Trillium's Provider Contact Information and Portals webpage.

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1915(i) service providers can refer to NCTracks to determine TCM assignment

1. Click on the Enrollment tab
2. Scroll down and click on the current date range
3. Enrollment Detail box will pop up
4. Click on the Tailored Care Manager NPI numbers in blue to see the assigned TCM.

If Trillium is the TCM, use the PCP/Provider Request for Care Manager Name or Assignment Referral Form.
Once completed, this form can be submitted to identify the Trillium TCM staff assigned to the member.