News

NorthSTAR TOC Letter

Date: 11/28/2016

Dear Behavioral Health Provider,

Effective January 1, 2017 all members currently enrolled in the NorthSTAR program receiving their behavioral health benefits through Value Options, will now receive benefits through Cenpatico Behavioral Health (Cenpatico) under Superior HealthPlan’s STAR+PLUS program.

The health and safety of our members – your patients – is our highest priority. In order to provide continuity of care for our members during this transition, Superior HealthPlan and Cenpatico will honor open authorizations for covered behavioral health services received from Value Options from January 1, 2017 until March 31, 2017, with the following exceptions:

  • Value Options will maintain responsibility for the episode of care for members that remain in an inpatient or residential treatment setting as of 1/1/2017. However, the facility is responsible for contacting us at

1-800-446-4089 for discharge planning purposes.  Professional fees should be billed to Cenpatico for dates of service on and after 1/1/17.

  • Providers must adhere to our authorization criteria for the following:
    • The provider wishes to render a service that is not covered under Cenpatico’s benefit structure. Provider must call 1-800-466-4089 with medical documents and these will be reviewed on a case by case basis.
    • The Value Options authorization expires before 3/31/2017.
    • The provider wishes to begin providing services to a new patient.

Providers may be contacted by Cenpatico to discuss the treatment plan and the effectiveness of the services being provided.  It is our goal during the transition period to review cases and administer a Cenpatico authorization if applicable. Adjustments may be made to the current authorization based on the review findings.

We look forward to working with you and your practice.  Please review the Frequently Asked Questions document enclosed with this notice.  Should you have any questions, please do not hesitate to contact us by phone at 1-800-466-4089.

Sincerely,

Pamela Cobb
Director, Provider Relations