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News & Press: Clinical Alerts

Important NEW Info about the Partners/Optum Transition

Thursday, January 31, 2019  
Posted by: Jamie Klufts
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Important NEW Information for Private Practitioners about the Partners/Optum Transition

 

This notice pertains to therapists who were out of network with Optum and Partners-only on 1/1/19, and are treating Partners employees and their families. If you were an Optum provider in 2018 and are still on the panel, or you received your new Optum or Partners-only contract by 1/1/19, you do not have to read this or do anything.
 
Allways/Partners has just clarified that they had given the professional organizations incorrect information. 
 
Contrary to what we heard in December, if you are out of network with Optum and Partners as of 1/1/19, you cannot simply continue to see your Partners clients. Rather, your Partners clients must request, fill out, and submit a Continuity of Care (CoC) form in order for you to get paid during the Transition of Care Period, which runs from from 1/1/19 through 6/30/19. This is only necessary for Partners employees and their families, not for AllWays commercial members (who used to be covered by NHP), or for MassHealth MyCare Family members, and only necessary if you do not have an Optum or Partners-only contract in hand.
 
 
You must have your Partners clients do this if:
  1. You applied to be either an Optum or a Partners-only provider, but did not receive your signed contract by 1/1/19, or 
  2. You are choosing to not apply to either panel
 
Be sure to tell your Partners clients to indicate on the Continuity of Care form that they are requesting Transition of Care benefits beginning 1/1/19.  
 
NASW has been told that AllWays and Partners will in fact backdate the request, but you will only get paid for sessions once the CoC form is in place; therefore, you should ask your clients to send in the form as soon as possible.
 
To be clear: this procedure is for continuity of care, in other words, for clients you were seeing before January 1 and will continue to see during the first six months of 2019. 
 
If you are not currently an Optum or Partners-only provider, you cannot start treatment with a new Partners member without getting a Single Case Agreement approved before you begin the treatment.
 
AllWays has let us know that further questions regarding this should be directed to Partners Health Plan: 844-451-3520. 
 
Meanwhile, all Optum providers and therapists currently treating Partners employees or their families should have received an email from AllWays Health Partners, with important facts about the transition. Please read it carefully. If you did not get it, you can access it here.
 
Additional information can be found in this FAQ for Behavioral Health Providers.
 
If you have additional questions regarding this transition, please contact one of Optum’s Provider Services Managers at 877-614-0484 or by email (see below). They have been very helpful and responsive.
 
Please be in touch if you have additional questions. Thank you to Erica Kirsners for her investigation and advocacy about this issue, and for gathering this comprehensive information. 
 
Sincerely,
Barbara

 

Barbara Burka, LICSW
Director of Clinical Practice
Director of Therapy Matcher

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