Kepro Changes: Behavioral Health Services in Atrezzo and Utilization Review

Attention Providers of Adult Behavioral Health Services: Atrezzo Changes  

Effective December 7, 2020, the Office of Behavioral Health, in coordination with Kepro is implementing several process changes. These changes will streamline workflow and decrease the amount of data collection portals utilized for adult behavioral health services.   

Provider trainings will occur virtually (information is below), and training materials will also be posted online.   

Please review the training materials and reach out to Kepro Provider Relations with questions about these materials materials or how to access the trainings at ProviderRelationsME@kepro.com.   

If your agency provides one of these services and has not accessed the Kepro Atrezzo Portal, please contact Kepro Provider Relations to give your agency access to the portal.  

Training Schedule  

Monday  November 30, 2020  10:00-11:00am	Atrezzo System Overview: (For Mobile Crisis, Veterans Case Management, Medication Assisted Treatment, Section 97 Appendix B Residential Services) Providers will submit registrations and discharges in the Atrezzo Portal at time of entry into service and at time of discharge. There will be no clinical review of these services.    To participate in the training, register online.    Can’t make the training?  See the video or PowerPoint (PDF).
Tuesday  December 1, 2020  1:00-2:00 pm	Section 97 Appendix E Adult Private Non-Medical Institution (PNMI) Referral Management and waitlist tracking: Referrals will be submitted to Kepro for clinical review of medical necessity and Section 97 policy criteria. Referral acceptance and response timeframes to and from the Office of Behavioral Health will be captured in the Atrezzo Portal. Prior authorization will be entered into the Atrezzo Portal once a member has entered the PNMI location. Members who are on an existing waitlist will be entered into the Atrezzo Portal.   To participate in the training, register online.   Can’t make the training?  See the video or PowerPoint (PDF).
Wednesday  December 2, 2020  2:00-3:00 pm	Invoicing: For Mobile Crisis, Crisis Stabilization Units, Assertive Community Treatment (ACT), Daily Living Support (DLS), Community Rehabilitation Services(CRS), Community Integration(CI), Medication Management, Veteran’s Case Management, Private Non-Medical Institution (PNMI) Appendix B/E/F, Supported Employment, Clubhouse, Medication Assisted Treatment, Substance Use Disorder Intensive Outpatient, Outpatient Counseling. Providers will submit invoices in the Atrezzo Portal for monthly service.   To participate in the training, register online.   Can’t make the training?  See the video or PowerPoint (PDF).
Thursday   December 3, 2020  1:00-2:00 pm	Serious Mental Illness (SMI) Terminations: (For Community Integration, Daily Living Supports, Community Rehabilitation Services , Assertive Community Treatment, Mental Health Outpatient) Providers will be required to submit a termination request in Atrezzo Portal for members with a serious mental illness.   To participate  in the training, register online.   Can’t make the training?  See the video or PowerPoint (PDF).
Friday  December 4, 2020  11:00-12:00 am	Critical Incidents: Critical Incident data will be collected through Atrezzo submission. When a critical incident occurs, providers will be required to complete a critical incident questionnaire in portal.   To participate in the training, register online.   Can’t make the training?  See the video or PowerPoint (PDF).

 

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Kepro Utilization Review Temporary Changes During the Emergency Period 

Effective November 21, 2020, the Office of MaineCare Services, in collaboration with the Office of Behavioral Health, Office of Child and Family Services, and Kepro, will implement the temporary changes outlined below to the Kepro utilization review process. These changes will be in effect for 60 days. The Department will reassess the need for additional extensions while the emergency period is in effect.                 

Temporary changes include:

• Members who are currently in service - Any member with a current authorization for service in the Kepro Atrezzo Portal will be automatically extended for an additional 60 days of service. Providers do not need to take any action to request this extension. Providers will be able to access the authorization end date, units, and Prior Authorization (PA) number in the Atrezzo Portal.
• Section 46, Child Inpatient Service - Members in this acute setting will have their authorizations extended to 14 days.
• Adult and Child Crisis Units - Members in this setting will have their authorizations extended to 14 days.
• Behavioral Health Homes and Opioid Health Homes services - These services will be extended to align with the attestation period and end on the 20^th of the month. 

Please note, the following reminders under the 1135 waiver: 

• Providers will continue to enter new admissions and new referrals to services into the Atrezzo Portal.
• Private Non-Medical Institutions (PNMI) authorizations will not be automatically extended. Please continue to enter continued stay reviews in Atrezzo Portal.
• Discharges will continue to be required in the Atrezzo Portal. Providers need to be sure they are processing discharges in Atrezzo in a timely manner as it may affect a member’s ability to receive services during the emergency period.
• Providers, at their discretion, may submit a Continued Stay Request for the full length of the authorization through the normal submission process within Atrezzo. All clinical information will be required as typical for this request. Providers may submit this request up to 31 days prior to the end date of the authorization.

For questions regarding the Kepro process or the Atrezzo Portal, please contact ProviderRelationsME@kepro.com. For billing questions, please contact your designated MaineCare Provider Relations Specialist.