 Provider Credentialing and Enrollment
Attention CURRENT SMC Providers:
As you are aware, Smoky Mountain Center (SMC) is a local management entity (LME) that currently monitors state mental health, intellectual and developmental disability, and substance abuse funding for its catchment area consisting of Alexander, Allegheny, Ashe, Avery, Caldwell, Cherokee, Clay, Graham, Haywood, Jackson, Macon, McDowell, Swain, Watauga, and Wilkes counties. SMC has received a designation to expand to become a Medicaid Waiver site which means that SMC will be a Managed Care Organization (MCO), effective July 1, 2012. In addition to managing state funds, SMC will be responsible for managing Medicaid funds for all behavioral health services for Medicaid enrollees whose county of Medicaid eligibility is within our catchment area. This impacts all direct enrolled agency providers and individual practitioners.
Prior to July 1, 2012, there are two very important steps necessary for your agency to complete in order to continue to provide and bill for Medicaid services effective July 1st:
- Those Licensed Independent Practitioners (LIPs) and Provisionally Licensed Practitioners (PLPs) currently employed by your agency must take part in SMC’s credentialing process; and
- Your agency must complete an enrollment application in order to contract with SMC so that you may continue to provide services within the SMC Provider Network as of July 1, 2012.
Please review the attached documents regarding credentialing of Licensed Independent Practitioners (LIPs).
Please contact providerinfo@smokymountaincenter.com if you have questions.
Provider Cultural Competency Plan and Requirements under Medicaid Waiver
Please be aware that as part of the requirements for the Medicaid Waiver, each Provider in the SMC Provider Network will be required to develop, implement, and maintain a Cultural Competency Plan for their agency or practice that is respectful and supportive of the cultural and diverse needs of consumers, families, stakeholders, communities, and other agencies. Cultural competency shall be a guiding principle that is reflected in Providers’ policies, clinical protocol, and established benchmarks and outcome measures.
Each Provider with a current State-Funded Contract, Medicaid Memorandum of Agreement (MOA), or Medicaid Billable Contract with SMC that intends to continue to contract with SMC under the Medicaid Waiver (beginning July 1, 2012) shall complete the Smoky Mountain Center Cultural Competence Self-Assessment Tool (Attachment 1) and submit to SMC’s Quality Management Department no later than July 1, 2012. This self-assessment tool will be required of all Providers in the SMC Provider Network annually at a minimum.
Please review the attached documents:
Please contact providerinfo@smokymountaincenter.com if you have questions.
Provider Timeline - Important Dates Providers Should Know
Provider Medicaid Waiver Timeline - Requires Internet Explorer (Uses ActiveX controls)
UPDATED 08/01/2011
Provider Medicaid Waiver Timeline - 1 Page per Month - Adobe PDF
UPDATED 08/01/2011
Advantages to the Public Management of the Medicaid Waiver
Public Managment of Medicaid Waiver and Advantages to Providers - Adobe PDF
Public Managment of Medicaid Waiver and Advantages to Consumers - Adobe PDF
Consumers and Families
NC State CFAC June 2011 Waiver Presentation - Adobe PDF
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