Behavioral health vendor to provide authorization training for freestanding substance abuse facilities Dec. 3

As reported in the September edition of The Record, authorization for treatment at freestanding substance abuse residential facilities will be required for Blue Cross Blue Shield of Michigan commercial PPO members, beginning in 2016. New Directions LLC will perform the authorizations.

This requirement will only apply to the substance abuse residential level of care, not outpatient. The current authorization requirements for residential treatment at hospital-based substance abuse facilities remain the same.

Also note that accounts that have behavioral health currently managed by a vendor other than New Directions will not be affected by this change. This includes, but is not limited to, the State of Michigan group account, auto groups, URMBT members and Denso Corporation.

Submit authorizations with WebPass
Admission authorization requests from freestanding substance abuse facilities will be made using the New Directions WebPass application. The authorization requests will also be made in accordance with New Directions’ medical necessity criteria, which are available here. WebPass is a secure Internet portal that allows providers to document and submit clinical information online to New Directions for initial authorizations and continued stay reviews. A demonstration of WebPass is available here.

Following a one-time facility registration process at the WebPass website, facility providers will receive individual user names and passwords used to log in to WebPass. As of Nov. 16, 2015, facilities can register as a user on WebPass. After logging in to the website, providers can enter a Blue Cross member ID (or name and date of birth information) to perform a variety of tasks related to the member. These tasks include admission requests and reviews.

A WebPass training webinar for freestanding substance abuse facilities is scheduled for Dec. 3, 2015. Details about this webinar will be emailed to these facilities and will also be posted on web-DENIS.

About New Directions
New Directions is a managed behavioral health organization accredited by the National Committee for Quality Assurance. It has more than 20 years of experience in utilization and case management services, in addition to extensive experience working with Blue plans nationwide. With its offices located in Kansas City, Missouri, New Directions currently manages Blue Cross’ employee assistance program.

Blue Cross members and providers benefit from a number of program and service enhancements that were previously unavailable, including:

• An award-winning service center providing 24/7 toll-free access for members and providers
• Integrated care programs that use an evidence-based approach to services for members across the continuum of care
• Discharge planning and follow-up appointment scheduling (for members admitted to inpatient and residential levels of care) that is closely monitored to ensure supportive transitions to and within the community.
• Case managers that work one-on-one with members to improve care transitions, foster self-management and remove barriers to care
• Use of claims data to build predictive models that identify members at-risk for relapse or readmission, and that subsequently enable targeted outreach efforts to these members

Visit ndbh.com for more information about New Directions.