ValueAdded

This is the 175th issue of our VBH-PA information update. These updates will be emailed to all network providers monthly. Please feel free to share our newsletter with others, and be sure your appropriate clinical and financial staffs receive copies.

Insidethisissue

ProviderConnect App ......... 2 New Fax Number for Greene Office .................... 2 CMS‐1500 Claim Form Updates .............................. 2 Website Updates ................ 2 Family Based Providers: Billable Travel ..................... 3 Transi on Phase: DSM‐5 Coding .................... 3 Provider Alerts .................... 3 14th Annual Consumer Forum…………………………..... 4 Seeking Ar sts! ................... 5 Nominate an Excep onal Individual .......................... 5 Artwork Release Form ........ 6 WPIC Videoconferences ..... 7

Vol.16Issue1January2014

Reporting Full Capacity

Providers are responsible for immediately notifying VBH-PA when they reach full capacity for any contracted level of care at any service location. Providers in the VBH-PA network must provide face-to-face intervention within one hour for emergencies, within 24 hours for urgent situations, and within seven days for routine appointments and specialty referrals.

Full capacity is considered the point at which the provider is unable to meet the access standards noted above or is unable to accept referrals for a particular level of care. Specifically for BHRS providers, you must notify VBH-PA if you are not able to provide any part of BHRS services (BSC, MT, TSS). For example, if you are at capacity for MT, then you would report just that. You would still receive referrals for BSC and TSS. Notices for full (100%) capacity should contain the reason for reaching capacity, the effective date, and the steps the provider will take to resume functioning at normal capacity.

To report capacity issues, please call our toll-free provider line at (877) 615-8503 and ask to speak with your Provider Field Coordinator. VBH-PA requests this information as a means to manage and monitor required HealthChoices access standards.

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ValueAdded—January 2014

For Our Providers in Rural Counties ProviderConnect App

Internet access may still be a problem in some of our rural counties, so VBH-PA wants you to be aware of the wireless “mobile-friendly” application (app) for ProviderConnect. This means that users can pull up and access the site via Internet Explorer, Safari, or whichever browser they have on their smartphones—iPhone®, iPod Touch®, and iPad®

Providers can access ProviderConnect via their smartphones by going to www.valueoptions.com. This will take you to the ValueOptions home screen. At the very top of the home page click on the “Mobile” link, then select the “Providers” tab. A confidentiality disclaimer will appear. Once you select “Continue,” you should be able to scroll down the page and see the same options you would typically see on the right-hand side of your screen when accessing ProviderConnect via your desktop.

If you want to experiment with the mobile site, select “Try the Demo.” This is the static ProviderConnect demo site but you will get the look and feel of what you will experience when you begin using the ProviderConnect mobile-friendly site.

The VBH-PA Greene County office fax server line has been replaced with a toll-free number . The number listed below should be used beginning January 1, 2014. By changing to toll-free numbers, it will allow simultaneous calls to be received by a number without the sender receiving a busy signal. Additionally, this helps us work towards our goal of “going green” as the faxes will be transmitted as files rather than printing out on paper.

New Fax Number for Greene Office

Department Fax Old Fax # New Fax #

Greene 724‐627‐5363 855-850-9831

CMS-1500 Claim Form Updates

WEBSITEUPDATES

Look for this column in our monthly newsletter for information recently posted to www.vbh-pa.com. 2012 RTF Provider

Profile Report Provider Profiling Reports

14th Annual Consumer

Recovery Information http://www.vbh-pa.com/

Requests for Proposals: Westmoreland County Methadone Treatment Services

. Medicare to Accept Revised Form Starting January 2014. The CMS-1500 Claim

Form has been recently revised with changes including those to more adequately sup-port the use of the ICD-10 diagnosis code set. The revised CMS-1500 form (version 02/12 ) will replace version 08/05 . The revised form will give providers the ability to indicate whether they are using ICD-9 or ICD-10 diagnosis codes, which is important as the October 1, 2014, transition approaches. ICD-9 codes must be used for services pro-vided before October 1, 2014, while ICD-10 codes should be used for services provided on or after October 1, 2014. The revised form also allows for additional diagnosis codes, expanding from four possible codes to 12.

Only providers who qualify for exemptions from electronic submission may submit the CMS-1500 Claim Form to Medicare. For those providers who use service vendors, CMS encourages them to check with their service vendors to determine when they will switch to the new form.

Medicare will begin accepting the revised form on January 6, 2014. Starting April 1, 2014, Medicare will accept only the revised version of the form.

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ValueAdded—January 2014

Welcome!

Kay Johnson started on December 9th as Manager of Clinical Services.

Kylee Rosevitik started on December 9th as a Member & Provider Services Representative.

Leona Cowan started on December 30th as a Provider Field Coordinator for Cambria County.

Joicelyn Weems started on December 30th as a Member & Provider Services Representative.

In response to Provider feedback regarding variable states of readiness to comply with the DSM-5 changes, VBH-PA has adopted a timeline to make the DSM-4 to DSM-5 transition as minimally disruptive as possible. The timeline is as follows: January 2014: We will accept information for clinical purposes (i.e. authorization requests) using the DSM-5 framework. It is not a requirement. Quarter 1 2014: DSM-4 screen layout will still exist in ProviderConnect; however, both DSM-4 and DSM-5 clinical diagnoses coding will be accepted. Quarter 2 2014: ProviderConnect screen layout will be modified to support the sun setting of Axis I-V framework and the adoption of the new DSM-5 model that we are implementing. New DSM-5 design details will be released closer to the roll-out date along with information on how to utilize new screen fields. It is important to note that during the transition phase providers will be able to submit diagnoses using either DSM-4 or DSM-5 coding. Please visit our website to review the most recent Frequently Asked Questions document and the accompanying ProviderConnect DSM-5 Screen Accommodations Guide for more detailed information. These documents are listed on our homepage at www.vbh-pa.com, “In the Spotlight” section on the top left-hand side of the screen. Direct links to these documents are listed below for your convenience. http://www.valueoptions.com/providers/Files/pdfs/DSM-5_Frequently_Asked_Questions.pdf http://www.valueoptions.com/providers/Files/pdfs/PC-DSM-5Screen-Accommodations-Guide.pdf

DSM-4 and DSM-5 Coding Accepted During Transition Phase

Family Based Providers, Please Note:

Units for travel when services are not rendered, are not billable. Please click here to view the PA Code in its entirety (55 PA CODE, CHAPTER 5260, Family Based Mental Health Services for Children and Adolescents).

Provider Alerts In an effort to better communicate with our providers, we are using email alerts to notify providers of the following:

Time sensitive information New information of an urgent nature Any changes/updates to VBH-PA policies/procedures

Alerts will also be posted on our website within five days of the email communication and archived for future reference.

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ValueAdded—January 2014

AttentionArtists!!

Value Behavioral Health is seeking artwork (paintings and illustrations) to use in marketing materials for this year’s Forum. See the next page for more info on how you may submit your artwork.

Save the Date Value Behavioral Health of

Pennsylvania Presents the

14th Annual Consumer Recovery Forum

Realizing Recovery—In All Aspects

Friday, April 4, 2014

Pittsburgh Marriott North

Cranberry Township

We are currently accepting exhibitor registrations and nominations

for the Leadership in Recovery Awards. Nominate an outstanding

individual from your county today! Visit our homepage at www.vbh‐

pa.com for the registration and nomination forms. General

registration for the Forum will also be posted there, so check back

often!

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ValueAdded—January 2014

For the past several years, Value Behavioral Health of Pennsylvania has reached out to HealthChoices members and others in recovery and with lived experiences requesting artwork (paintings or illustrations) for its Annual Recovery Forum. Once again, the Forum Planning Committee, comprised of HealthChoices members, peer specialists, CFST members, and other stakeholders, is accepting electronic images (JPEG or PDF) of artwork to be used on materials created for the Forum. Materials include the registration brochure, conference agenda, and other materials prepared for the day of the Forum. Only one image will be chosen, but all work will be acknowledged. Please consider submitting artwork or passing along this information to others who may be interested in submitting artwork. The name of this year’s Forum is “Realizing Recovery—In All Aspects.” Please send all artwork, along with the release form (located on the next page of this newsletter), completed and signed, to Suzanne.klaus@valueoptions.com. The deadline for submission is January 24, 2014.

14th Annual Consumer Recovery Forum — Seeking Artists!

14th Annual Consumer Recovery Forum Realizing Recovery—In All Aspects

Seeking Nominations! Nominate an individual for the Leadership in Recovery Awards

The purpose of the Leadership in Recovery Award is to acknowledge HealthChoices members who are actively engaged in their recovery and to encourage other members in their recovery process. To acknowledge their journeys, VBH-PA will publicly recognize HealthChoices members who have demonstrated courage, creativity, and leadership along their journeys. This is not a cash reward, but an acknowledgement in the form of a beautifully designed keepsake that will be customized and presented on April 4, 2014 during the 14th Annual VBH-PA Consumer Recovery Forum.

Please nominate at least one HealthChoices member residing in your county* whom you feel is deserving of this type of recognition. The deadline to nominate is Wednesday, February 20, 2014. Visit our homepage at www.vbh-pa.com for the nomination form. Nominate an outstanding individual today!

*HealthChoices members residing in Armstrong, Beaver, Butler, Cambria, Faye e, Greene, Indiana, Lawrence, Washington, and Westmoreland coun es are eligible. Mercer, Crawford, and Venango HealthChoices members will have the opportunity to be nominated at other regionally located VBH‐PA Forums in 2014.

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ValueAdded—January 2014

Please send all artwork, along with this release form, completed and signed, to: Suzanne.klaus@valueoptions.com. The deadline for submission is January 24, 2014.

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ValueAdded—January 2014

Winter 2014 WPIC Videoconferences VBH-PA is pleased to announce that our service center will once again be a videoconferencing site for the WPIC Office of Education and Regional Programming videoconference series. These programs are free of charge and there are NO fees for continuing education credits.

The videoconferences are held from 9:00 a.m. to 11:00 a.m. in the Walnut Room at VBH-PA’s Trafford Service Center. You are invited and welcome to attend.* For CEU information, registration information, and complete descriptions of these trainings, please click here.

Upcoming Videoconferences:

New for 2014—DSM-5 Videoconferences!

January 15—Autism Spectrum Disorder and Intellectual Disability in DSM-5 January 29—The Evolution of Psychosis in the DSM-5 February 12—DSM-5: Changes in Substance Abuse February 26—Mood Disorders in DSM-5: What’s New and What’s Not March 12—Feeding and Eating Disorders in DSM-5 March 26—DSM-5: The Diagnosis of Dementia to Meet Real World Needs

and Sleep/Wake Disorders

Registration:

To register for these trainings, please visit the ValueOptions Provider Trainings Web page. Select Pennsylvania from the state dropdown list (DO NOT change any of the other fields) and then click on Select. Scroll down the screen and put a check mark in the box next to the event(s) and then hit Register. Phone-in registrations will not be accepted.

*Please Note: These videoconferences are NOT webinars. You must be in attendance at the Trafford Service Center to view these videoconferences. VBH-PA is one of many sites offering this opportunity. Please click here to view all locations offering this videoconference series. To register with another location, please contact the coordinator for that site.

Suggestions or ideas for articles that you would like to see published in ValueAdded can be faxed to Kim Tzoulis, ValueAdded Editor, at (724) 744-6363 or emailed to kimberly.tzoulis@ valueoptions.com

Articles of general importance to the provider network will be considered for publication. Value Behavioral Health of PA, Inc. 520 Pleasant Valley Rd Trafford, PA 15085 Phone: (877) 615-8503 Fax: (724) 744-6363 www.vbh-pa.com