Western Highlands Network
Friday E-Mail Newsletter
Number 92
3/23/2007
The Friday E-Mail is a weekly update for providers by the Services Management Department of Western Highlands Network. Please distribute to all your staff.
Western Highlands Network Announces New Substance Abuse Target Population
WHN is pleased to announce the addition of a new IPRS target population for Adult Substance Abuse; Adult Substance Abuse Engagement and Treatment (ASTER), effective March 19, 2007.
The following is an excerpt from the communication bulletin sent out by the NC Division of MH/DD/SA:
The addition of this target population will immediately assure statewide eligibility for substance abuse assessment and treatment services for an adult consumer with a primary substance abuse or dependence disorder who is not already eligible for services through a current target population.
The purpose of the Treatment Engagement and Recovery target population is to promote broadened eligibility for primary substance abuse treatment services for which a provider may be reimbursed. It is our goal that the addition of this new target population eligibility will enhance LME efforts to develop a provider system that supports an accessible and responsive service array for primary substance abuse consumers. Client eligibility criteria for this population includes those adults who are ages 18 and over with a primary alcohol or drug abuse disorder and who require substance abuse services initiation, engagement, and/or continuity of treatment services and supports for relapse prevention and recovery stability. Services should be immediately available to this population, and will generally be limited in duration and intensity.
LMEs and their contract agencies will be reimbursed retroactively to July 1, 2006 for designated MRS substance abuse assessment and treatment services that have been provided per Division standards by licensed, certified, and qualified substance abuse professionals, associate professionals, and paraprofessionals to consumers that meet the eligibility for this new adult substance abuse target population.
A period of "blanket presumptive eligibility" covering substance abuse assessment and treatment services provided to this population group will be approved for services provided between July 1, 2006 and June 30, 2007. During the July 2006 through June 2007 period of presumptive eligibility, it will be permissible for providers to bill for all covered services delivered to this population even though the period of service for some consumers may exceed the two 90-day eligibility periods that are being established for ASTER target population consumers within a single fiscal year, effective July 1, 2007.
A follow-up communication will provide LMEs with further technical details regarding the eligibility requirements for this target population.
IMPORTANT UPDATE FROM VALUEOPTIONS
Faxing Information to ValueOptions
Please follow the directions provided to get authorization requests to ValueOptions:
- For all Mental Health/ Substance Abuse (except inpatient) requests fax to : 919-461-0599
- For all CAP/TCM/DD requests fax to: 919-461-0669
- For all Health Choice requests fax to: 919-379-9035
PLEASE USE THE CORRECT FAX NUMBER FOR EACH REQUEST. DO NOT USE ANY OTHER FAX NUMBER UNLESS DIRECTED TO BY VALUEOPTIONS.
NOT USING THE APPROPRIATE NUMBER FOR THE APPROPRIATE REQUEST WILL DELAY A RESPONSE TO YOUR REQUEST.
Thank
you for your attention to this request.
Charlie Schoenheit
Director of Services Management
Western Highlands Network
356 Biltmore Avenue
Asheville, NC 28801
Telephone: (828)258-3511 x2219
FAX: (828) 225-2779
E-Mail: Charlie@westernhighlands.org
Website: westernhighlands.org
