NC-TOPPS Provider Training CONTRACT PERFORMANCE UNIT VAYA HEALTH – 2018-2019
Training Goals
Understand NC-TOPPS and related requirements
Know your role as a NC-TOPPS superuser, user or data entry user
Know how to administer and submit interviews
Increase awareness of NC-TOPPS guidelines and know where to get updates
Understand how to obtain a CNDS#
Know who to contact for NC-TOPPS questions
What is NC-TOPPS?
North Carolina Treatment Outcomes and Program Performance System (NC-TOPPS)
Web-based system for gathering outcome and performance data
Provides reliable information that is used to measure the impact of treatment and to improve services and management quality throughout the service system
Managed and required by N.C. DMH/DD/SAS
Common Terms and Acronyms
MCO – Managed Care Organization
PHI – Protected Health Information
QP – Qualified Professional – for purposes of NC-TOPPS, any person responsible for conducting NC-TOPPS interviews
DEU – Data Entry User
Member – Person receiving services, also called consumer or client
Zixmail – Secure e-mail system used by Vaya Health
LME/MCO Responsibilities
Local oversight – MCOs are responsible for ensuring providers meet NC-TOPPS requirements
Provision of identification numbers – MCO Assigned Record Number and Common Name Data Service Number (CNDS#)
Verification of provider agencies – for QPs that sign up with a provider not currently in NC-TOPPS
Training and technical assistance
Changing of QP access – when members transfer to a new provider
Provider Responsibilities Having an active superuser who oversees NC-TOPPS for the agency
Data confidentiality
Confidentiality of a member’s health information is protected under North Carolina laws and federal regulations
PHI is only shared with persons with a legal right to the information
Members may have access to their NC-TOPPS information upon request
Completion of NC-TOPPS interviews
QPs are responsible for completing all interviews with members Interviews are completed faceto-face with the member* NC-TOPPS updates are kept upto-date
* Interviews completed by telephone contact with the member are the next option, if necessary; interviews completed from service records are a last option used only if the member refuses to participate.
Benefits of NC-TOPPS Provider benefits
The individual report can help drive Child and Family Team or Adult Recovery Team discussions on progress and planning
NC-TOPPS provides supporting documentation for service requests
The dashboard provides a look at agency site and service outcomes
NC-TOPPS provides data for driving service and agency quality improvement
Data can be used to establish benchmarks for internal monitoring and network or state comparisons
Positive agency outcomes can be a good marketing tool with community stakeholders
The simple query report provides basic member and provider demographic and service information
Benefits of NC-TOPPS DMH/DD/SAS benefits Monitor
outcome performance by service, provider, LME/MCO and statewide
Provides data
to meet SAMHSA block grant monitoring
requirements Provides data
on state mental health/substance use system performance for the public, N.C. DHHS leadership and the Legislature
Whom to Contact with NC-TOPPS Questions
NC-TOPPS – NCTOPPS@ncsu.edu
MCO superusers – NCTOPPS@vayahealth.com
Password and personal account issues Deleting episodes or duplicate interviews Correcting incorrect record number and date of birth
Switching members between providers CNDS #s Error messages
Agency superusers
Finding episodes completed by QP in-house Switching between QPs at same provider
Getting Started NC-TOPPS homepage The
NC-TOPPS Outcomes at a Glance 2.0 dashboard measures outcomes for particular age/disability groups by local area, provider agencies and services
NC-TOPPS
Quick Start Guide includes interview forms and superuser tools
NC-TOPPS
2.1 website allows you to submit outcome information for individuals receiving services, create a new user account and manage system information
Becoming an NC-TOPPS User
Go to the NC-TOPPS 2.1 website and click "Create New NC-TOPPS User Profile."
Answer the questions.
Receive a user name assigned to you at this time.
Remember this user name and password. You will need them to gain access to the NC-TOPPS system.
Follow the onscreen instructions to select LME/MCOs and provider agencies.
When choosing an agency, use the dropdown box and pick an existing provider and address.
Once your request has been accepted, you will be notified by e-mail.
Data Entry Users (DEUs)
DEUs are individuals within a provider agency who are allowed to enter NC-TOPPS interview data on behalf of QPs.
Users may request DEU status while adding provider agencies.
All requests for DEU status are emailed to the superuser, who will subsequently approve or deny requests.
Creating a New NC-TOPPS User Account Video One: Creating a New NC-TOPPS User Account
Superusers
Each LME/MCO is required to have superusers to provide technical assistance to providers.
Each provider is required to have superusers. Manage Transfer
NC-TOPPS compliance for agency
NC-TOPPS from one agency location/QP to another
Remove
QPs no longer at agency
How to Become a Superuser ď ľ
New users need to enroll in NC-TOPPS as a user and be approved before they can apply to become a superuser.
ď ľ
Current users should contact the NC-TOPPS Help Desk at nctopps@ncsu.edu to request a Superuser Enrollment Form verifying that you have authorization to access the data.
Important Reminders
Having the member present for an in-person interview is expected.
NC-TOPPS interviews must be entered into the web-based system by the QP or DEU
Copies of all submitted NC-TOPPS interviews must be included in the member’s service record.
Additional Important Reminders
A Release of Information must be provided with the request when a member’s provider agency changes. The QP at the new provider agency must notify the MCO so the MCO superuser can change the NC-TOPPS to the new provider QP.
The member’s QP in the provider agency is the person responsible for ensuring that NC-TOPPS interviews are completed.
Consent and Confidentiality
Any email communications containing private health or sensitive information (PHI/SI) must be sent to Vaya Health securely. Vaya uses Zixmail to send and receive secure email.
Providers must ensure an appropriate Release of Information (ROI) or consents are in place when sharing information and completing NC-TOPPS.
The primary provider agency may share a member’s PHI only with those provider agencies explicitly named on the signed consent form.
The consent form must be renewed at least annually.
Who Gets an NC-TOPPS Interview?
ď ľ
Members who have been formally admitted to the LME/MCO and are receiving qualifying mental health and/or substance use disorder services from a public-funded source
ď ľ
Vaya Health Members with NC Health Choice receiving Therapeutic Foster Care
Residential Services Requiring NC-TOPPS
Level II and Level III Residential Services
Psychiatric Residential Treatment Facilities
SA Community Residential Treatment
Therapeutic Foster Care
Opioid Treatment Programs (OTP)
All OTPs are required to participate in NC-TOPPS: Private-pay/self-pay: The
provider will register with the NC-TOPPS Help Desk at nctopps@ncsu.edu.
Medicaid/non-Medicaid-funded: The
provider will use the
LME/MCO assigned record number.
If a member changes from Medicaid/non-Medicaid-funded to private pay (or vice versa), the provider should contact the NC-TOPPS Help Desk to request the change.
Dual Diagnosis Members ď ľ
Members who receive intellectual and developmental disability (IDD) services and supports as well as mental health (MH) or substance use disorder (SUD) services require NC-TOPPS participation only when the services are predominantly treating MH or SUD needs
Qualifying Service Codes Requiring NC-TOPPS 90832-90838* 90846* 90847* 90849* 90853* H0004* H0004 HQ* H0004 HR* H0004 HS* YP831 YP832
YP833 YP834 H0005* YP835 H0015 H0040 H2015 HT H2022 H2033 H2035 YP630 YM645
H2023 U4 H2026 U4 H0035 H2012 HA H0020 H0012 HB H0013 H0019 H2020 YA230 YP780 S5145
*If the member has an SUD diagnosis and is only receiving outpatient services with these service codes funded through Medicaid Basic Benefits, the member is not expected to participate in NCTOPPS.
For updates to this list, please refer to Appendix A of the NC-TOPPS Guidelines
Members Receiving Multiple Services
When a member is receiving more than one qualifying service, responsibility for completing NC-TOPPS interviews is determined by a hierarchy of services based on age and disability.
The provider of the service in the highest order in the NC-TOPPS hierarchy is responsible for NC-TOPPS interviews (see next slide).
As services change, the NC-TOPPS record will be transferred to the provider agency providing the next highest level of services in the hierarchy.
NC-TOPPS Hierarchy Adults
Child/Adolescent
Residential Services
Residential – PRTF
Partial Hospitalization
Partial Hospitalization
Assertive Community Treatment (ACT) Team
Multisystemic Therapy Services (MST)
Substance Abuse Comprehensive Outpatient Treatment (SACOT)
Substance Abuse Intensive Outpatient Treatment (SAIOP)
Substance Abuse Intensive Outpatient Treatment (SAIOP)
Child and Adolescent Day Treatment Residential Services (except PRTF) and Therapeutic Foster Care Services Supported Employment Periodic (non-Mediciad-funded SUD only) High-Fidelity Wraparound
Community Support Team (CST) Opioid Treatment Supported Employment Periodic (non-Mediciad-funded SUD only)
Intensive In-Home Services (IIH)
Exceptions
Members receiving only one or more of the following services: MH Outpatient Therapy and/or Medication Management
Psychosocial Rehabilitation
Crisis Services
Psychiatric Inpatient Hospitalization Services
Developmental Disability Services and Supports
Members in the Adult with Developmental Disability (ADSN) target Population or in the Children with Developmental Disability (CNDSN) target population are not required to participate in NC-TOPPS.
Timeframes for Submitting NC-TOPPS Interviews ď ľ
Initial interviews should be completed with the member during an in-person interview by the second treatment visit.
ď ľ
Initial interviews should not be submitted before the member is formally enrolled with the LME/MCO.
Timeframes for Submitting NC-TOPPS Updates
Three-month update: 90 days following the initial episode submission
Six-month update: 180 days following the initial episode submission
12-month update: 365 days following the initial episode submission
Biannual updates: 18 months, 24 months, 30 months, etc., after the initial submission (until the episode completion is submitted)
Preparing for the Interview
NC-TOPPS interviews include a common set of items that are generally collected as part of developing and revising a MH and SUD member’s treatment plan.
It is important that the QP is familiar with the interview questions prior to contacting a member.
Careful preparation will increase the chances of engaging the member and completing NC-TOPPPS interviews with accurate information.
Conducting the Interview
NC-TOPPS interview questions can be used as a tool during a QP-member discussion to help identify areas of concern.
Interviews for children (ages 6-11) should be conducted with the child’s parent/guardian or other adult responsible for the child’s care.
Interviews must be submitted through the NC-TOPPS system on or before the due date.
Interview Reminders ď ľ
Please note that all items in the interview are required to be answered before you can submit the interview.
ď ľ
There are also certain items on the Update and Episode Completion interview that are required to be asked directly to the member either in-person or via telephone.
ď ľ
The QP should refrain from providing opinions, advice, feelings or suggestions for answers.
Helpful Tips
Use the LME/MCO assigned record number. (Do not make up a number or use the provider-generated record number.)
If the record number does not have enough digits, add a zero to the beginning of the number (ex. 1234 becomes 01234). Do not add zeros to the end.
Use the CNDS# assigned to the member. (Do not make up a number or use the Social Security Number.)
More Helpful Tips
Check the correct spelling of the member’s name.
Make sure to use the correct date of birth (this information can be found in AlphaMCS).
After submitting NC-TOPPS, look for the green checkmark at the top of the page to make sure the information was accepted.
Submitting NC-TOPPS Interviews Please see the videos below on Submitting NC-TOPPS Interviews. Video 2- Submitting Initial NC-TOPPS Interviews
Video 3-Submitting NC-TOPPS Update Interviews
Common Name Data Service Numbers (CNDS#) The
LME/MCO is required to give the provider agency the LME/MCO assigned record number and the CNDS# or Medicaid number when a member is enrolled.
If
a member has Medicaid, use that number for the CNDS#.
To
obtain a CNDS# for Vaya Health members, e-mail the following information to nctopps@vayahealth.com: First
and last name (no nicknames); Date of birth; Social Security Number; Gender; Race/ethnicity; Language spoken
Provider Change If a member transfers to a new provider agency and will continue in a service requiring NC-TOPPS … The
new QP should contact the MCO superuser to request NC-TOPPS be transferred.
For
Vaya members, e-mail nctopps@vayahealth.com, provide the Release of Information, the address of the provider and the name of the QP who will be responsible for submitting NC-TOPPS.
The
new QP will continue the current NC-TOPPS updates based on the schedule established by the previous agency.
Episode Completion Episode Completion interviews must be submitted when a member has: Successfully
completed treatment and is not continuing in a service that requires NC-TOPPS
Been
discharged at the program initiative
Refused Not
treatment
received any services for 60 days
Transitioned Moved Been
to a service that does not require NC-TOPPS
out of area or changed to different LME/MCO
incarcerated or institutionalized
Passed
away
Features Available to Users
Interview Search: Searches for interviews by various criteria
Updates Needed List: Assists in tracking the dates when updates are due for a member
Individual Report: Displays select NC-TOPPS items from the initial interview and the two most recent updates for a member
Searching for Interviews
Once logged in, click on the “Locations” tab and select the correct LME/MCO (and provider location, if applicable).
Click on the “Reports” tab, then click on “Interview Search.”
You can search for all interviews associated with your profile by clicking “Find Interviews” with no criteria items selected, or you can add criteria on the left to narrow the search.
To find an interview that was started, but not submitted, choose “Website Submission” and click on “Manage Episode of Care.”
Updates Due
After logging in and choosing an LME/MCO, click on the “Reports” tab
Click on “Updates Needed.” This is the list of all members who currently have an interview due.
At the bottom of the page, you may choose “Print” or “Export Data.”
Locating Specific Interviews Video 4: Finding a specific Interview
Video 5: Locating Interviews Needing Updates
How to Request Assistance
For assistance with Vaya members, email nctopps@vayahealth.com.
Use encrypted email when sending PHI.
Provide your name and agency (include address).
Provide at least two forms of information about the member (name, date of birth, record number).
State the issue or question. Transfer
a member (provide the ROI)
Received an
error message (give the specific message)
Pre-Test: True or False A. B. C. D.
Every provider andLME/MCO is required to have a superuser. (True / False) Only superusers can submit NC-TOPPS interviews. (True / False) When a member transfers from one provider to another, the NC-TOPPS should transfer with them. (True / False) If I have a question about NC-TOPPS, there is no one who can help me. (True / False)
Answers: A. True – A provider can have more than one, but every provider should have at least one superuser. B. False – QPs and DEUs can also submit NC-TOPPS interviews. C. True – Contact the MCO’s Superuser and request that the NC-TOPPS be transferred. D. False – Review the NC-TOPPS manual, ask your agency superuser or e-mail nctopps@vayahealth.com or nctopps@ncsu.edu.
Pre-Test: Multiple Choice 1.
After a member enters into a service requiring NC-TOPPS, the initial interview should be submitted when? a)
At any time, as long as the person is still receiving services
b)
During the first or second treatment visit
c)
Within the first month of services
d)
Within the first 90 days
Correct answer is: (b) The NC-TOPPS interview should be submitted by the second treatment visit.
Pre-Test: Multiple Choice 2.
NC-TOPPS updates are required at three months, six months, 12 months and biannually. How are the timeframes calculated? a)
The three-month interview is due 90 days after the initial is submitted; the six-month is due 180 days after the initial is submitted, etc.
b)
The three- and six-month interviews are submitted any time as long as the person is still receiving services.
c)
The reviews are based on the member’s birthday.
d)
None of the above
(a) The three-month interview is due 90 days after the initial is submitted, the six-month is due 180 days after the initial is submitted, etc.
Pre-Test: Scenario 1 3.
Your agency is providing ACT services to a member, and after four months, the member is transitioning to another provider for ACT services. What will you do with NC-TOPPS?
Answer: If the member is continuing services at a new provider agency, the new QP must contact the member’s LME/MCO so that the LME/MCO superuser can change the member’s NC-TOPPS submissions to the new QP/provider agency. If the new agency fails to request the transfer, contact nctopps@vayahealth.com for assistance.
Pre-Test: Scenario 2 4.
Your agency is providing Intensive In-Home Services to a member who has transitioned home from Residential Services. You are unable to submit an NC-TOPPS because there is already an open NC-TOPPS in the system. What do you do?
Answer: Contact the LME/MCO NC-TOPPS superuser at nctopps@vayahealth.com and provide your name, agency address, the name of the member and a copy of the signed Release of Information form allowing the NC-TOPPS information to be transferred to your agency. NOTE: Your agency will continue with NC-TOPPS submissions based on when the initial NC-TOPPS was submitted by the previous provider.
Take the Test If you would like to receive a Certificate of Training, please click the “Take the test� button.
This concludes the NC-TOPPS presentation. If you have additional questions, please e-mail nctopps@vayahealth.com.