BHI Provider Bulletin
March 2016
Issue II, Volume 16
Inside this Issue:
Revalidation &
Enrollment
May is Mental Health
Month
20th Annual Recovery
Gala
BHI Form Update
News from our Providers
Colorado Crisis
Services
REVALIDATION / ENROLLMENT for
MEDICAID
PROVIDERS INFORMATION
42 CFR 455.414 - Revalidation of enrollment, as required by the Affordable Care
Act, means all currently enrolled Medicaid and Medicare providers and suppliers
must r evalidate their enr ollment infor mation under the new enr ollment
screening criteria. All existing Colorado Medicaid providers (including providers
that are currently enrolled through an MCO or BHO) must undergo revalidation
prior to November 2016.
Providers will revalidate using the new online provider enrollment tool. By revalidating, providers will also be enrolling into the Colorado interChange, an updated
Medicaid Management Information System (MMIS) that launches in November of
2016. For more information, please visit the Colorado Medicaid revalidation page.
Important HCPF Update
Program Improvement
Advisory Committee
New Auditing Process
Wellness Events
Free Provider Training
Required Documents
FAQ’s
ICD 10 FAQ’s
May Is Mental
Health Month!
Mental Health America, a community
based nonprofit, will
lead the observance of
May is Mental Health
Month again this
year.
The observance of May is Mental Health Month was created in the 1950’s and now
reaches millions of people through media, local events, and screenings. Each year,
Mental Health America, and its affiliates, work to educate the public about mental
health, advocate for those living with mental illness, and promote mental health
services.
The theme for this year’s campaign is Life with a Mental Illness. Mental Health
America encourages that people get involved by taking a screening at
mhascreening.org if they think they are showing signs/symptoms of mental illness.
Specific focuses of this year’s campaign are to help others figure out if they are
showing signs of mental illness, to help break down discrimination and stigma
surrounding mental illness, and to show others that they are not alone. Get involved
with May is Mental Health Month by wearing a green ribbon, participating in
events such as the NAMI walk, or finding some other way to stamp out
stigma! http://www.mentalhealthamerica.net
20th Annual Recovery Gala
BHI commemorates May is Mental Health Month by hosting our annual
Recovery Gala. The event raises awareness for behavioral health
conditions by celebrating the recovery and resiliency efforts made by our
members, friends, family members, mentors, employees, and community
partners.
This year’s Recovery Gala will feature speakers who have experiences
of living with mental illness and are passionate about advocating for
others who live with mental illnesses. In addition to keynote speakers,
the event will serve as a venue for BHI to showcase poetry written by
our members. BHI members were encouraged to submit original poetry
to illustrate a Trauma-Informed Care Principle and convey its purpose in
their life and recovery. Three finalists’ for each of the six principles (a
total of 18 finalists) will have their work on display at the Gala.
Attendance to the Gala is by invitation only. Click here to submit your
nomination!
BHI Forms were updated!
BHI has new and improved clinical forms! These newly updated forms
will help providers ensure that they are meeting documentation
standards as per regulatory guidelines. We have made these forms
simple to use so as to assist our providers in completing the forms with
ease. While the use of the BHI forms is not required, we are suggesting
that you use these forms, which will only further assist you in
completing documentation that meet the guidelines and standards. The
updated forms have been conveniently uploaded to the BHIcares website
(link listed below). Please replace all former versions of these forms
with the new ones!
http://bhicares.org/for-providers/clinical-forms/
Also, BHI has begun to implement a new and improved way to ensure
that the absolute best quality of care is being rendered to our members!
In an effort to ensure all member needs are being met, we are
incorporating some additional screening questions within our clinical
forms. These newly added questions will help the provider assess the
possibility of developmental disabilities/needs of our members, allowing
to more adequately identify the best and most appropriate level of care
for those individuals who have taken the step towards living a fuller,
healthier and happier life!
Si no sabe por dónde empezar a buscar ayuda para problemas mentales,
abuso de sustancias o problemas emocionales, llame a Colorado Crisis
Services. Ya sea que llame para usted o para un conocido, le ofrecemos
ayuda profesional, confidencial e inmediata. También le ofrecemos
información, referencias y conexiones para más asistencia y
soluciones. 24 horas al día, 7 días por semana, y 365 días al año.
1-844-493-TALK(8255)
http://coloradocrisisservices.org
News from our
Providers
Community Reach Center
Community Reach Center operates a
Weekend Walk-In Clinic located at
8989 Huron St., Thornton, CO
80260. The location is open Saturday
and Sunday from 8am-5pm and no
appointments are necessary. The
Weekend Walk-In Clinic can provide
support for anyone experiencing
family disputes, grief, depression,
anxiety stress or anger. All ages
welcome, regardless of funding
source.
For more information call
(303) 853-3500.
Aurora Mental Health
Need more direct web access to
helpful behavioral health news,
educational materials, and self
screenings? Aurora Mental Health
Center has launched a new Library &
Information Center on their website.
Featured topics include Addictions,
Parenting, Stress Reduction and
Management, and much more!
Visit http://www.aumhc.org to
check out the Library & Information
Center, accessible on the bottom
right of the page.
Arapahoe/Douglas Mental
Health Network
Arapahoe/Douglas Mental Health
Network is Part B Medicare
providers, and does not accept Part A
Medicare. In addition, they do not
offer partial hospitalization.
For more information regarding
Medicare coverage, contact
(800) 633-4227. For more
information regarding Arapahoe/
Douglas Mental Health Network’s
services, contact (303) 730-8858.
Share your Suggestions!
Do you have a suggestion to include in the next provider Bulletin? If
so, we want to hear all about it!
Please submit your ideas to us.
Mail: Attn: Pr ovider Relations Repr esentative ,1290 Chamber s
Road, Aurora, Colorado 80011
Fax: Attn: Pr ovider Relations Repr esentative ,(303) 364 - 2240
Email: info@bhiinc.or g
Colorado Crisis Services
Colorado Crisis Services is the new statewide mental health crisis system.
The goal of the program is to help make behavioral health care services
accessible for all ages both in person and on the phone 24/7/365. Call the
Colorado Crisis Support Line at 1(844) 493-TALK (8255) or find mor e
information on the web at http://coloradocrisisservices.org.
HCPF Update
Health First Colorado
Starting in May 2016, Health Care Policy and Financing (HCPF), Colorado’s
Medicaid Program, will change its name to “Health First Colorado.” The
new name and logo will better represent Colorado’s fresh approach to public health care coverage. Over the past few years, program enhancements
have included new benefits, expanded eligibility to cover a greater number
of Coloradans, member access to care information via mobile device, and
more. The Department looks forward to sharing more information about
Health First Colorado with you in the coming months. Beginning as early
as March 20, 2016, cards printed from Colorado.gov/PEAK will have the
Health First Colorado name and logo.
In June 2016, all hard copy cards sent to newly enrolled members will reflect the Health First Colorado name and logo. Current cards are still valid;
members do not need to request new cards. As a reminder, members are
only required by the Department to furnish their photo ID at appointments;
Health First Colorado cards are not required to receive services.
You are Invited
You are invited to attend our Program Improvement Advisory Committee
(PIAC). PIAC was established to recommend implementation strategies for
the requirements outlined in the Health Care Policy and Financing contract
held by Behavioral Healthcare, Inc. (BHI). This meeting is open to the
public. We look forward to meeting you and assisting BHI to improve our
members’ healthcare experience.
BHI – 1290 Chambers Rd. Aurora CO 80011
April 26, 2016
9:00AM – 10:30AM
Please visit ww.bhicares.org for future dates and times.
Resource
Hotlines
If you or someone you know is
having a mental health or substance
use crisis:
1(844)493-TALK
For 24/7 medical information, ask
the Medicaid Nurse Advice Line:
1(800)283-3221
To report child abuse:
1(800)4-A-CHILD
For LGBTQQI Youth who need
confidential, free, and
non-judgmental support:
1(800)268-YOUTH
If you are a student who needs to
anonymously report threats against
you, your friends, or your family:
1(877)542-SAFE
Three good reasons to quit tobacco:
your family, your health, your
money:
1(800)QUIT-NOW
New Year….New Auditing Process!
BHI has revamped our auditing process! Historically, BHI has conducted audits based on claims data and compliance of billing standards. Only a small portion of our auditing process in the past has been focused on the actual
quality of documentation within the clinical records. We believe it is important to have a more complete picture of
what is happening on the provider end as a means of further enhancing the services being provided to our members.
Moving forward, we will have two individuals from the BHI team come to the providers to conduct a thorough
Compliance, Quality and On-Site review. The Compliance Monitoring Specialist will review claims data specifically for compliance with the Uniform Service Coding Standards Manual (USCSM). This audit is based on claims that
have been billed by the provider and paid for by BHI. In addition, a Provider Quality Monitoring Specialist will be
present for these reviews, with the specific task of reviewing the full clinical record of each unique member identified within the claims data as well as conducting an on-site review. The purpose of this new process is to help BHI
become a better educator and supporter to our providers and to assist our providers in enhancing upon their existing
skills as it pertains to the quality of care being provided to our members. For more information regarding this new
process please click on the link below: www.bhicares.org or contact Bonnie Wright at: BWright@bhicares.org or
Ann Doering at: ADoering@bhicares.org .
Frequently Asked Questions
My child needs an evaluation for ADHD. Should I see a physical health or behavioral health
provider?
Both physical health and behavioral health providers can complete evaluations for ADHD, however it is recommended that children complete the evaluation with a behavioral health provider. If a child ends up needing further
services and/or medication this allows for a smoother transition to a more long-term behavioral health provider. If
you need assistance getting linked to behavioral health providers who work specifically with children you can log
onto bhicares.org and use our provider search tool, or call the Member Services Line at (303) 361-8100, option 1.
Does BHI cover services to individuals with a primary diagnosis of autism or related developmental disorder (TBI, Asperger’s, etc.)?
It varies. Members can access providers who specialize in Developmental Disorders through BHI. However if the
diagnosis has already been deemed organic, members need to seek providers through their assigned RCCO (physical
health provider list). If members are requesting an ABA behavioral treatment specialty, MSO reps can do an advanced provider search on BHI’s website for providers who work with developmental disorders. And then with that
list MSO reps can then search for the provider’s profile at Psychologytoday.com for an enhanced view of their clinical specialties.
I have more questions. Where can I find additional information?
If you have more questions, give us a call at (303) 361 - 8100. We can help answer questions regarding authorizations, substance use services, claims, eligibility, filing or voicing a complaint, finding a provider, navigating the
Medicaid system and your benefits, and much more. You can also check out our BHI website at www.bhicares.org
for more information
Wellness Events
BHI will be hosting a variety of presentations promoting overall health and wellness topics throughout the year. To
participate, and for further information, please sign up online at http://bhicares.org/wellness-program.
For further questions please contact Vicky Garza at 303-361-8143.
April
BHI will be hosting a Youth Health and Wellness Fair in Adams County. Resources will include: Nutrition information, health weight information, safe driving tips and more! We will also be hosting a presentation at our Wellness and Recovery Committee Meeting on Tuesday April 19th, at 12:00pm. The location for the meeting is 2200
W. Berry Ave Littleton Colorado 80120. Lunch will be provided at this presentation.
May
May is Mental Health. BHI will be participating in the NAMI Walk on Saturday, May 21 at Centennial Center
Park. Sign up online!
June
BHI will be partnering with a local organization to discuss with our members the importance of quitting smoking.
July
We will be discussing the nutritional health. Our members will learn tips on shopping healthy and how to create
healthy meals with those items.
August
August is eye health month. Our members will learn of resources that can assist them with vision degeneration and
can ask questions about maintaining healthy eyes.
September
September is SAMHSA’s National Recovery month. BHI will host a health fair to assist our members with gathering resources to assist them on their journey of recovery.
October
BHI will be completing screenings for community members for National Depression Screening Day.
November
November is Diabetes awareness month. BHI is inviting any and all members to join us for a conversation to discuss ways to prevent diabetes and maintain a healthy and balanced lifestyle for those living with diabetes.
Never give up on someone
with a mental illness. When ‘I’
is replaced by ‘we’, illness
becomes wellness.” -Shannon L. Alder.
Free Provider Training!
BHI has a NEW
Opioid Addiction Presentation Compliance Director!
BHI would like to invite you to attend a presentation about
opioid addiction.
Recovery-Oriented Care: Addressing the Multiple Principles of Recovery From Opioid Addiction
This program will review opioid addiction as a chronic
condition affecting a patient’s physical, mental, and social
health. The focus of the talk is on recovery-oriented care to
address the multiple pathways to recovery and the physician’s role in this process.
Feel free to contact Earl Della Barca if you have
any questions regarding compliance, privacy, or
fraud, waste, and abuse
Office: 303-361-8154
Compliance Hotline: 303-361-8153
Email: edellabarca@bhiinc.org or
compliance@bhiinc.org
Event Date: Monday, May 16th, 2016
Time: 12:00pm-1:30pm Lunch will be provided
Speaker: Steven Wr ight MD
Location: BHI Administr ative Offices
1290 Chambers Road
Aurora, CO 80011
Mesa Verde Room (capacity 75 attendees)
Please RSVP to:
Emily Schrader, LPC, CACIII
BHI Clinical Substance Use Coordinator
eschrader@bhiinc.org
“BHI is committed to help
you find your way through
mental health care. We'll
work together to offer the
best professional support
to you and your family”
Please review the following documents on
our website:
Member Rights and Responsibilities
How to File a Complaint about your services (Grievance Process)
Both documents need to be distributed to each client upon intake to ensure clients are aware of their Member
Rights and Responsibilities and the process to file a complaint. If you have any questions regarding these forms
or the process, please contact the Member Services Department at 303-361-8100 ext. 1.
BHI Providers:
ICD-10 Diagnosis Code Crosswalk
On April 1, 2014, the President
signed into law legislation passed
by the House and Senate delaying
ICD-10.
BHI DROP-IN CENTER
INFORMATION
Center Point – (303) 730-8858
The Centers for Medicare and
Medicaid Services (CMS) has announced the new compliance date
for health care providers, health
plans, and health care clearinghouses to transition to ICD-10 is
October 1, 2015.
2200 West Berry Avenue
Littleton, CO 80120
The Department of Healthcare Policy and Financing (HCPF) has created a crosswalk for converting
covered diagnosis codes from ICD9 to ICD-10. This list of codes is
effective October 1, 2015 and will
be required on all claims billing for
date-of-service October 1, 2015
forward.
Rainbow Center – (303) 361-8180
• ICD 10 FAQ
• ICD 10 Mental Health and Substance Use Disorder Covered Diagnosis List
Uniform Service Coding Standards
Manual: The 2015 version of the
Uniform Service Coding Standards
Manual is available. Changes from
the 2014 version to the 2015 version are noted in blue throughout
the new manual. All providers will
need to be compliant with this new
manual by August 1, 2015. A link
to the full manual can be found
here.
Community Connections – (303) 361-8200
12455 East Mississippi Ave
Suite 104
Aurora, CO 80012
690 West 84th Avenue
Thornton, CO 80260
What is a Drop-in Center?
BHI Drop-In Centers are Member/Peer-Driven programs that are run in
partnership between BHI professionals and those who have experienced
a mental illness. The Drop-in Center programs include educational opportunities, social opportunities, support groups, peer counseling and
recreational activities.
Purpose of BHI Drop-in Centers
BHI Drop-in Centers create a safe, friendly environment for members to
support their recovery. At our Drop-in Centers, we believe empowering
individuals is critical to the success of their recovery. Our Drop-in Centers empower members by involving them in day-to-day tasks and
providing creative activities that support their growth, recovery, and
overall well-being.
Recovery and Resilience
Recovery means different things to different members. For some, it
simply means being able to overcome symptoms and engage in activities they find interesting. For others, recovery is the ability to find purpose and to stay on the path toward fulfilling that purpose, despite a disability. Resilience is the ability of a member and his/her family to adapt
and overcome difficulties in the process of recovery.
For More information visit www.bhicares.org or click here