Temporary Changes to ACHN Care Coordination, PCP/DHCP Referrals, and Medical Management Meetings


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TO: Alabama Coordinated Health Network (ACHN) Participating Providers and ACHN Entities
Due to concerns with the Coronavirus pandemic, the Alabama Medicaid Agency (Medicaid) is making temporary changes to the ACHN Entities and requirements for participating providers.

ACHN Care Coordination
Effective immediately and until April 16, 2020, ACHN care coordinators can perform care coordination activities telephonically. The telephonic care coordination will encompass all activities and processes of face-to-face care coordination. Medicaid will only consider successful telephonic contacts for reimbursement. Medicaid will release further guidelines outlining the provision of telephonic care coordination in a formal policy and procedure. Other than this change in method of care coordination, the ACHNs’ normal operational activities, including provider and recipient telephone lines shall function according to the approved program operations.

Providers are asked to continue to participate and collaborate with the ACHNs and to encourage their patients to actively participate with the ACHN care coordinators for telephonic care coordination services.

PCP and DHCP Referrals 
Medicaid will temporarily lift the Primary Care Provider (PCP) and Delivering Health Care Provider (DHCP) referral requirement effective for one month, expiring on dates of services  April 16, 2020.
There are no changes in the way claims are to be submitted. Providers will continue to see error status codes on the remittance advices but will see the claims paid during this time period. Any Medicaid provider whose services require a PCP or DHCP referral will be affected. Please refer to the Provider Billing Manual Chapters for the provider type and services performed.

Medical Management Meetings
ACHN Entities who have scheduled an in-person Medical Management meeting in the next several days can provide a webinar in lieu of the in-person meeting. ACHN Entities shall give attendees credit for in-person participation if they have already participated in a webinar during a previous quarter.

The Medical Management meetings will provide opportunities for updates from the ACHN Entities and Medicaid as well as opportunities for Providers to provide input to the ACHN Entities of issues they are encountering during this state of emergency. The meeting attendance by webinar in lieu of the in-person meeting will be available until April 16, 2020.


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