What is behavioral health?

It is the care a member receives if they need mental health, drug or alcohol treatment. As your Medicaid health plan, Absolute Total Care will now be responsible for both the inpatient and outpatient parts of this benefit. In the past, we handled only the inpatient care.

Members and providers were mailed letters about this update. But if you have any questions, please contact our Provider/Member Services Department.

Providers can learn more here.

“Paul brings a strong operational background to Absolute Total Care and will be working with the leadership team to provide excellent service to members, providers and the State of South Carolina,” said Mark Eggert, interim chief executive officer, Absolute Total Care, and executive vice president of health plans, Centene Corporation. “He is a seasoned healthcare executive whose experience and knowledge will help Absolute Total Care improve the quality of care and the health outcomes of our members, which is a top priority for our health plan.”

Accardi, a veteran healthcare professional, worked for both Liberty Health Advantage and MDNY Healthcare in New York. His experience includes multiple executive management positions in the healthcare sector, as well as the finance and accounting industry.

Accardi earned a bachelor’s degree in business administration with a concentration in accounting from Hofstra University, a master of business administration degree in corporate finance and investment theory from Adelphi University and master of healthcare policy and management degree from Columbia University. He holds several executive certifications, including negotiation from Harvard University School of Law and Six Sigma Quality Management from Villanova University.

Crimm joined Centene Corporation, Absolute Total Care’s parent company, in 2005 at its Georgia subsidiary, Peach State Health Plan, where she served as senior director of quality from December 2005 to January 2009. While there, she secured New Health Plan NCQA accreditation for Peach State Health Plan. Under Crimm’s guidance, Absolute Total Care obtained its highest score in company history from the National Committee for Quality Assurance (NCQA) New Health Plan accreditation as well.

Crimm’s healthcare career spans over 25 years with an emphasis in advancing quality initiatives. Her background includes leadership positions at top healthcare organizations — Emory University Hospital, Matria Healthcare and BlueCross BlueShield of Georgia. A registered nurse with clinical experience, Crimm is a graduate of St. Joseph’s College of Maine with a bachelor’s degree in healthcare administration. She earned a master’s degree in business administration from St. Joseph’s College of Maine, as well as Certification in Professional Healthcare Quality (CPHQ) and Six Sigma certification. Crimm is a member of NCQA’s Health Plan Advisory Council.

Absolute Total Care is working with Edifecs to ensure a successful transition to the new formats.  Trading partners are required to complete HIPAA Version 5010 testing and certification using the Centene Edifecs Ramp Management Testing Facility.  To obtain access to the HIPAA Version 5010 Companion Guides, sample files, and FAQs trading partners must enroll on the Centene Edifecs Ramp Management site: www.centene.com/edifecs

Additional information regarding HIPAA Version 5010 will be communicated on the Centene Edifecs Ramp Management site and distributed to trading partners that have enrolled for testing on the Centene Edifecs Ramp Management site.  

Questions? Contact the EDI Helpdesk at ediba@centene.com or 1-800-225-2573 X25525.

ATC members affected by this change will receive letters via mail notifying them to choose another health plan available in their county. These members should call South Carolina Healthy Connections Choices (SCHCC) at 1.877.552.4642. ATC members are encouraged to have the names of their doctors and Medicaid ID number when they call. The choice period is from August 19 to September 20, 2011. Members who do not choose a new health plan will be assigned to another health plan effective October 1, 2011.

Additionally, Absolute Total Care members in Greenville, Laurens and Pickens counties will receive letters via mail notifying them of their option to select another health plan. Members can call SCHCC at 1.877.552.4642 to make this change. The choice period is from August 19 to December 20, 2011. If no selection is made, the member will remain an Absolute Total Care member. Absolute Total Care is committed to serving its members and appreciates the opportunity to serve them. We understand that both members and providers may have questions about this change. Please call Absolute Total Care at 1.866.433.6041 (TTY/TTD 1.866.912.3609) or SCHCC at 1.877.552.4642 for assistance.

“We are very proud to have Peter join our team, especially as we position Absolute Total Care for long-term growth. He has extensive experience in healthcare network development, including credentialing, contracting and provider relations. These particular areas are essential to having a strong provider network that allows our members access to quality care,” said Brace.

Bachini has more than 24 years of experience in the healthcare and health insurance industries. Most recently, he served as senior vice president of health plan services for Parkview Health System in Fort Wayne, Ind. before joining Absolute Total Care. Other previous experiences in healthcare include senior executive positions with four of the largest national payors – AETNA, Blue Cross and Blue Shield, United Healthcare and CIGNA.

Bachini earned a bachelor’s degree in physiology from State University of New York at Buffalo (SUNY). He is a member of several professional healthcare associations, including the National Association of Health Underwriters, the American College of Healthcare Executives, the Academy for Healthcare Management and the Healthcare Financial Management Association.