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Providers
NOTICE: BILLING SUBMISSION DEADLINES FOR MEDICAID CLAIMS ONLY
As OPC converts to its new business system, effective July 1, 2010 it is necessary to implement a Medicaid claims billing submission deadline.
All Medicaid claims with service dates prior to July 1, 2010 should be submitted on OPC's Excel spreadsheet to opctickets by these claims submission deadlines:
Claims with service dates on or before April 30, 2010: DUE TO OPCTICKETS BY JUNE 30, 2010
Claims with service dates May 1 - 31, 2010: DUE TO OPCTICKETS BY JULY 30, 2010
Claims with service dates June 1 - 30, 2010: DUE TO OPCTICKETS BY AUGUST 29, 2010
We appreciate your assistance and cooperation as OPC transitions to its new business system.
Karen Strum
OPC Billing and Reimbursement Manager
CST/IIH/Day Treatment Transition Plans
As you are aware, the current State Plan Amendment will allow only Critical Access Behavioral Health Agencies (CABHA) to provide Community Support Team, Intensive In-Home, and Day Treatment services effective July 1st. Although an extension has been requested from CMS, the state has not yet heard whether it will be granted.
If the extension is not granted, it will be crucial that consumers of these three services are successfully transitioned to CABHA certified agencies. Therefore, we are asking that agencies currently providing these services begin immediately planning for this possibility. We understand that you have a relationship with these consumers and do not wish to unnecessarily disrupt their treatment based on an event that may or may not happen. However, just as you plan for continuity of services in the event of a disaster, proactive and thoughtful planning will help mitigate the impact on your consumers and facilitate a smooth transition if necessary.
Similarly, we understand that some providers, even if CABHA certified, may cease providing CST on July 1st because of recent service definition and rate changes. If your agency has made such a decision, you will, of course, need transition plans for those consumers as well.
As a first step in this planning process, we are asking that providers of CST, IIH and Day Treatment give us aggregate information related to your current OPC caseload and a plan for how you will transition those consumers prior to July 1st if required. We are not asking for individual consumer transition plans at this point, although we may do so in the future. We simply want providers to begin thinking about how your agency will manage these potential, significant changes to our service system.
Please return this form to your provider representative by June 9th. (Also available in.pdf)
Provider Relations & Quality Management
OPC’s Provider Relations & Quality Management Department focuses on provider community development and management, including technical assistance, accreditation, credentialing, endorsement, oversight and monitoring of all external contract and catchment area providers.
The Department is also responsible for management of all issues related to client rights, confidentiality, incident review, client outcome assessments, research and evaluation review, maintenance of all policy and procedure manuals, coordination of the guardianship function for the LME, accreditation of the LME and coordination of HIPAA and Title VI compliance.
Due to a significant increase in requests for Letters of Support for Level III Child/Adolescent Residential Treatment Facilities, OPC is currently utilizing an application process. Applications will be evaluated in collaboration with our community partners and letters of support will be issued to those agencies who can best meet the needs of the population. The application can be accessed by clicking on the link Request for Application.
Please note, we are still currently issuing letters of support for residential facilities licensed under Section .5600 - Supervised Living for Individuals of all Disability Groups. To request letters of support for these facilities, please contact Cim Brailer at 919-913-4150.
Staff and Contact Information
Senga Carroll
Clinical Specialist
Ph: (919)913.4146
Fx: (919)913-4038
- Provider Monitoring
- Evidence-based practice
- Model fidelity
- Provider training
Lynne Hamlet
Department Director
Ph: (919)913.4037
Fx: (919)913-4038
- Confidentiality - HIPAA
- Medical Records
- Quality Assurance
- Title VI
Zach Lutwick
Provider Relations Representative
Ph: (919)913.4061
Fx: (919)913-4038
- Technical Assistance and support
- Provider Contact
Laura McKay
Guardianship Coordinator
Ph: (919)913.4036
Fx: (919)913-4038
- Provider Monitoring
- Evidence-based practice
- Model fidelity
- Provider training
Paula Newman
Clinical Specialist
Ph: (919)913.4133
Fx: (919)913-4038
- Provider Monitoring
- Provider Training
- Evidence Based Practice
- Model Fidelity
- Lending Library
Michael Norton
Client Rights Coordinator
Ph: (919)913.4079
Fx: (919)913-4038
- CFAC
- Client rights
- Client Rights Committee
- Confidentiality
- Incident reporting
- NC-TOPPS and COI
- National Core Indicators
Debbie Santucci
Accreditation & Credentialing Specialist
Ph: (919)913.4075
Fx: (919)913-4038
- Endorsement of catchment area providers
- Accreditation and credentialing of providers via QI review
- Provider Monitoring
Phyllis Williams
Provider Community Manager
Ph: (919)913.4085
Fx: (919)913-4038
- Technical Assistance and support
- Provider Contact
- Provider email list
Contact us for more info
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