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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services

All DHHS info for health care providers


Provider Monitoring Information

The revision of the tools was done under the auspices of the DHHS-LME/MCO-Provider Collaboration Work Group, which includes representation from the NC Providers Council, Benchmarks, the Professional Association Council, and LME-MCO representatives from the NC Council of Community Programs, the Division of Medical Assistance, the Division of Health Service Regulation, and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. The new process for routine provider monitoring was implemented March 1, 2014.

The Provider Monitoring process is used statewide by the LME-MCOs to monitor providers of publicly-funded mh, idd and sa services, regardless of funding source, and includes the tools and guidance for monitoring licensed independent practitioners (LIPs) and mh, idd and sa provider agencies. Routine provider monitoring consists of two components--a routine review and a post-payment review. 

The DHHS provider monitoring tools are completely automated for the purpose of tool administration, documentation, scoring, and generation of reports.  The automation of these tools is in direct response to Session Law 2009-451 (SB 202), which directed the Department to explore and implement procedures to reduce the administrative burden on LMEs and providers in demonstrating compliance to state requirements. Instructions for completing the tools are included in the workbooks. 

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