2020 Provider Compliance Forum and OMHSAS PHE Regulations Update, September If you are a behavioral health provider interested in joining our network: Note: While Independence transitions to a directly contracted behavioral health network, behavioral health providers contracted with Magellan will continue to be considered in network through 2023. LGBTQI Nondiscrimination MA Bulletin Diagnostic & Statistical Manual of Mental Disorders, January These documents are helpful as you determine the services you would like to be contracted to provide. MA Bulletin D&A Outpatient Clinic Medication Management Visit, March Learn ways to stay healthy with AmeriHealth's benefits, programs, and rewards. 2013 Year in Review and PA Website, November Give us a call at Missed Appointments & No-Shows Charges, May The new Texas Clinicians Postpartum Depression Toolkit is intended to be a resource for Texas clinicians on screening, diagnosis and treatment of postpartum depression. Magellans Primary Care Physician (PCP) Toolkit. The PHQ-2 consists of the first two items from the longer Patient Health Questionnaire-9, which consists of nine items that align with the DSM criteria for major depression. Group Therapy in Partial Hospitalization Policy Clarification See key details from the, You are on primary menu. Enter your company name in the search box, select the group name from the drop-down, check the box at the bottom and then click the "Go" button. At Magellan in Wyoming, we keep you informed to help you provide the best care for the members we serve. 1-888-968-7241. We offer a variety of training options to fit in with your busy schedule. If you have a new practitioner joining an Independence contracted group that does not contract with Magellan, initiate the credentialing process at Independence by. 194 0 obj <>/Filter/FlateDecode/ID[<470ED8A1BD01B641B1E787351A1B9B3A><7E42C025AB3D25449CC58577CE294D23>]/Index[165 54]/Info 164 0 R/Length 131/Prev 128485/Root 166 0 R/Size 219/Type/XRef/W[1 3 1]>>stream Commonwealth of Pennsylvania | Web Portal | Main Magellan Healthcare, Inc., an independent company, manages mental health and substance abuse benefits for most Independence members. RTF Bed Hold and Therapeutic Leave Guidelines, July Progress Note Sample with CD Check-Off, June Medical Assistance Provider Self-Audit Protocol Compliance Forum Resources Enhanced Behavioral Health services seek to keep Virginians well and thriving in their communities, reduce the need to focus on crisis by investing in prevention and early intervention for mental health and substance use disorder (SUD) comorbidities, and support a comprehensive alignment of services across the systems that serve Medicaid members. Provider Self-Audits and Self-Reports of Fraud, Waste, or Abuse, March Educational Requirements for Behavioral Specialist Consultant Services, 2015 Compliance News To request an application, contact your Network Contact. Together, we can leverage our strengths and experience to improve outcomes for the youth and families we serve. You can download the toolkithere. Provider Self Disclosure Claims Recovery Template, January Provider Self-Reports of Fraud, Waste & Abuse Click here for the latest information about COVID-19 and Wyoming's High Fidelity Wraparound, You are on primary menu. PDF Medi-Cal Rx Web Portal Registration and Training Update Click the link below to find the provider portal for your needs. CMS 1500 Provider Disclaimer, October LGBTQI Affirmative Environments MA Bulletin, June Magellan Provider's Home Page Informational Guidance Mandatory Reporting On April 1, 2017, Virginias Medicaid Program launched an enhanced substance use disorder treatment benefit Addiction and Recovery Treatment Services (ARTS). Psychiatric Outpatient Clinic Chapter 5200 Compliance Guide, October QEN 2.0 Referral Guide (10/21) QEN 2.0 Suitability Assessment + Review - Referral Form (Guide) (10/21) QEN 2.0 Reconsideration Request and Outcome Form (Guide) (10/21) Magellan of Florida QEN Referral Forms Payment for Diagnostic Laboratory Services in Outpatient Drug & Alcohol Clinics Active network providers. Updated Peer Support Services Bulletin and Provider Handbook, 2019 Compliance News Project BRAVO services were included in that rate increase. A pathology provider is joining an existing participating hospital-based pathology group in a participating hospital in our service area (as identified above). The following professional provider networks have limitations to participation: The pathology provider network is closed for new office-based pathology providers in the AmeriHealth service area (i.e., participating counties in Pennsylvania, Delaware, and Maryland) except when the pathologist meets the following condition: Note: Pathologists cannot be added to participating non-pathology practices. Its purpose is not to establish a final diagnosis but to screen for depression as an initial approach. Clinical. File a Claim | Magellan of PA To see scenarios where CRNPs are only allowed to be contracted and credentialed with AmeriHealth, please read this. Youll have a career path that builds on the life experiences of the growing professional. Provider Self-Audits and Self-Reports of FWA There are many opportunities available to help you live a healthy, vibrant lifestyle. 2022 Magellan Health, Inc. All Rights Reserved. Magellan of Florida QEN Presentation. Outpatient Psychiatric Oversight Act, August Billing | Magellan in Wyoming Psychiatric Rehabilitation Services Home Delivery Provider Order Form. MA Bulletin TCM Documentation Please refer to the steps above to complete the contracting/credentialing process. Recovery Support Services Minimum Program Requirements Update, April 165 0 obj <> endobj Our integrated solution combines our pharmacy benefit and specialty pharmacy expertise into an organization, allowing us to leverage our collective scale and experience in managing total drug spend, while ensuring a clear focus on the specific needs of each of our . OHSU Health IDS PROVIDER MANUAL 07/2023 Contact Information OHSU Health IDS Customer Service P: 844-827-6572 Hours 7:30 a.m. - 5:30 p.m. weekdays Provider Handbook Psychiatric & Partial Hospitalization Services, October You can simplify this process using the Council for Affordable Quality Healthcares (CAQH) online credentialing application: CAQH ProView. Provider Information and Forms | Magellan of Florida Provider Focus - Contact Us Any professional provider interested in participating in our network must also complete and return a credentialing application kit. TCM Refresher Training, January Share insights, make an impact You still have an opportunity to join Magellan's provider advisory group, Provider iMput. Skip to article content, Medicaid Behavioral Health Services Provider Manual, LACSoCproviderquestions@magellanhealth.com, Behavioral Health Services Provider Manual, LA Department of Health Health Standards, CSoC Service Providers offering any of the four specialized CSoC services to children and youth, Child and youth providers serving children and youth who are in CSoC. This new site may be offered by a vendor or an independent third party. 2022 Magellan Health, Inc. All Rights Reserved. Provider discounts. When the provider is located in counties outside of Chester, Montgomery, Delaware, Philadelphia, and Bucks counties, When the provider is joining an existing participating group, When a non-participating provider is purchasing the assets of a participating provider, and the participating provider is terminating their AmeriHealth agreement. In addition, some sites may require you to agree to their terms of use and privacy policy. All Medi-Cal Rx providers, including pharmacies, prescribers, and their staff, will need to complete secure Web Portal registration in order to access education and outreach training calendars, training course enrollment, and resources located in the Medi-Cal Rx Learning Management System (LMS), Saba. December Theres no need to resubmit information that should stay the same. Completing the credentialing process can take hours if you fill out paper forms. Chapter 5221 ICM Interested behavioral health providers can contact Magellan by selecting the "Join the Network" link or by contacting their Magellan Provider Services Line at 1-800-788-4005 for assistance. Youll also find past issues ofProvider Focus. Partial Hospital Group Services March 27, 2023: Provider FAQ for MA Unwinding Process Starting April 1, March 13, 2023: Students, Alumni, and Young Professionals Are Invited to a Job Fair on April 13 at Penn State-Lehigh Valley, February 27, 2023: Suicide Risk Assessment Protocol Provider Notification & Expectations, February 10, 2023: 12-Month Process for MA Unwinding Starts April 1 Please Review Resources Available, February 9, 2023: Please Share This Video Immediate Job Openings in Behavioral Health, January 27, 2023: Survey Status Update for Provider Access and Capacity, January 5, 2023: Updates to MNC for Assertive Community Treatment with Continued Stay, January 3, 2023: Return to Prior Authorization Requirements on February 1, 2023, December 21, 2022: Provider Town Hall Recording from December 19, December 21, 2022: 2023 Lehigh Valley Job Fair for Health & Human Services is April 13, December 1, 2022: Availity Learning Center Resources, November 29, 2022: QI Update on Adverse Incident Reporting, November 3, 2022: Team Up Against Hunger Food Drive in Bucks County and Montgomery County through December 16, October 26, 2022: November 1 Change Use Availity Essentials to Access HealthChoices Claim Status, October 24, 2022: OMHSAS Reminder of Governor Challenge Training Portal to Prevent Suicide, September 14, 2022: Provider Town Hall Recording, June 30, 2022: New Email Addresses for ASAM and COE Inquiries, June 1, 2022: Document Submissions and Requests, May 19, 2022: Information about Public Health Emergency (PHE) and Medical Assistance, April 5, 2022: Regulatory Suspensions Extended, March 21, 2022: RFP Residential Treatment Facility Adults, February 25, 2022: ASAM Update 3.7 Level of Care, January 19, 2022: OMHSAS Behavioral Health Telehealth Surveys, January 12, 2022: COBA Notification Update, December 22, 2021: December 17 Provider Town Hall,Powerpoint,Updating Provider Information, December 3, 2021: CMS Interim Final Rule Announcement, November 5, 2021: Survey Reminders for Provider Access and Capacity, October 18, 2021: Magellans Updated Telehealth FAQ, October 1, 2021: OMHSAS Update on Telehealth and Regulations September 30 Announcement, September 30, 2021: Magellans Updated Telehealth FAQ, September 10, 2021: Magellans Telehealth FAQ, August 31, 2021: Magellan Provider Town Hall, August 27, 2021: OMHSAS Telehealth Update Bulletin OMHSAS-21-09, August 20, 2021: Waived and Suspended Licensing Regulations, June 15, 2021: Provider Performance Standards are Available on our Website, April 7, 2021:EAC RFP Procurement Notice;EAC RFP;EAC RFP Budget Forms, March 8, 2021: Member Feedback and Substantiated Complaints, February 12, 2021: Update to Prior Authorization Requirements, January 29, 2021: COVID-19 Vaccine Information in Pennsylvania, November 24, 2020: A Note of Appreciation for Our Network of Providers, November 19, 2020: COVID-19 Survey Reminders for Providers, October 9, 2020: Bucks County Virtual Training Childrens Crisis Diversion and De-Escalation Strategies in the Community Setting, September 18, 2020: Magellan Provider Town Hall, July 28, 2020: DHS Announces Redesigned MA ACCESS Cards, July 7, 2020: COVID-19 Provider Announcement, COVID-19 Telehealth Memo From Magellan May 22 Edition, COVID-19 FAQ From Magellan May 21 Edition, May 20, 2020 Email: COVID-19 Emergency Change in Authorization Process, Best Practices For Discharge Planning in Family Based Services:Recording,Presentation, COVID-19 FAQ from Magellan April 2 Edition, COVID-19 Telehealth Memo from Magellan April 2 Edition, Jan. 17, 2020: IBHS/BHRS transitional authorization process for current BHRS/ABA providers, Oct. 22, 2019 Provider Town Hall in Cambria County, Sept. 5-6, 2019 Provider Town Halls in Eagleville, Allentown, July 31, 2019: All Inclusive and Exclusive Contract Language, July 22, 2019: Modification to Approved Training on ASAM Criteria, Certified Peer Support Certification Announcement, Certified Peer Support Grandparenting Application 3.1.18- 8.31.19. Learn more about our credentialing criteria. MA Provider Self-Audit Protocol, February ORGANIZATION PROVIDER APPLICATION If you respond "yes" to any of the liability questions, please submit documentation describing the incidents or cases involved. The Practitioner Participation Form is only for credentialing applications. Telehealth and Signature Requirements, November Click here for the latest information about COVID-19 and Wyoming's High Fidelity Wraparound, You are on primary menu. Call: 318-524-8829, 4. ASAM Alignment Update & Extension Requests, April Gail Fowler If you have a primary practice address in Pennsylvania or Delaware and would like to join our network(s), you must notify AmeriHealth by submitting a Practitioner Participation Form. Other Adobe accessibility tools and information can be downloaded at https://access.adobe.com. Reminder about Minimum Documentation Requirements, June CRNP, PA, & RN Services in Outpatient Clinics, September Addiction Recovery And Treatment Services. Yes. Changes impacting Background Clearances for staff, August Maintaining Active Licensure and MA Enrollment, February Compliance Year in Review 2019, November Outpatient Group Therapy Independence will provide an email outlining what documents are needed. Medical Assistance Payment for Certain Diagnostic Laboratory Services, May Network area Pennsylvania and Delaware Provider Self-Monitoring and Subsequent Self-Reports/Self-Disclosures of Fraud, Waste or Abuse (FWA), 2020 Compliance News individuals misrepresented material facts on the application for Medicaid benefits or failed to report changes that, if known, would have . Any other new providers interested in providing Medicaid behavioral health care services should reach out to theHealthy Louisiana Plans. Join the network. The CAQH ProView online application is free to providers and helps practices save money on administrative resources. Targeted Case Management Compliance and Regulatory Reminders, March Those interested in becoming a provider will submit their following information with their application. Member Newsletter: July is BIPOC Mental Health Awareness Month Summer 2022 Compliance Resources Under My Practice, go to "Submit a Claim Online". We developed this orientation in collaboration with our providers. Provider Websites and Secure Portals Looking for information about about being a Magellan provider or where to log in to your account? EAP. MagellanProvider For Magellan Healthcare Behavioral Health providers Click here to access MagellanProvider RadMD Compensation & Progress Notes, March To view this file, you may need to install a PDF reader program. Once your credentialing application has been approved, you will receive an email from DocuSign with the standard contract, if required. The training and scope of practice of the collaborating physician must be consistent with the practice of the CRNP. Skip to article content, Magellan of Florida Qualified Evaluator (QE) Listing. This makes it easier for members to get help for their mental health and drug or alcohol concerns. Effective January 1, 2023, we are insourcing the network and are directly contracting with behavioral health providers. Community Incident Management & Reporting Get connected with your local county resources. 23219For Medicaid EnrollmentWeb: www.coverva.orgTel: 1-833-5CALLVATDD: 1-888-221-1590. The member handbook includes details about benefits and other helpful information: PA Member Handbook Bucks, Cambria, Lehigh, Montgomery, and Northampton Counties, Manual para miembros Bucks, Cambria, Lehigh, Montgomery, and Northampton Counties. Skip to article content, Provider Portal: https://wyoming.dyp.cloud/, The Acknowledgement Letter recognizes that you are a provider. CRNP Services in Outpatient Clinics, March Boletin para el miembro: Consejos de bienestar y cuidado personal durante la COVID-19 Otono 2020 Claims Eligibility Utilization Management (Prior Authorizations) Long Term Services and Support (LTSS) Provider Administered Drugs Referral Requirements STAR Kids Referral and Authorization Process Electronic & Paper Submission Edits Education & Reference Education and Reference Blue Review Education Materials Electronic Visit Verification (EVV) Utilization Management (Prior Authorizations), STAR Kids Referral and Authorization Process, Value-Added Services for STAR, CHIP and STAR Kids, Medicaid Provider Information on COVID-19 Coverage, Quality Improvements (QI) Toolkits and Tip Sheets, Home Delivery Pharmacy (Mail-Order Pharmacy), Medicaid (STAR) and CHIP Prior Authorization Forms, Medical Providers Behavioral Health Toolkit, Magellan HealthCare Provider Focus News and Information, Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth with Autism (English), Medicaid Applied Behavior Analysis (ABA) Services for Children and Youth with Autism (Spanish), Applied Behavioral Analysis (ABA) Provider FAQ. Click hereto view our Monthly Compliance Alerts. Forms - Magellan Provider The PHQ-2 inquires about the frequency of depressed mood and loss of pleasure or interest over the past 2 weeks. Requirement to Report Changes in Licensure, April D&A Lab Services The GAIN-SS is a brief five minute instrument designed to quickly and accurately screen general populations of both adults and adolescents to detect psychiatric disorders, substance use disorders, or crime and violence problems. hb``f``x-01G43023->c~"bSk:L Psych Rehab Regulations, May Once you complete steps one, two and three, we will send a contract/agreement. Increased referrals. Select Contract Support Supervisor in the form below Compliance and Fraud, Waste & Abuse Resources, March The CAQH ProView online application makes it quick and easy for you to stay current by allowing you to update only the information that needs to change. Magellan chose the following screening tools: The Global Appraisal of Individual Needs-Short Screener (GAIN-SS)|Short Screener Description, The Patient Health Questionnaire two-item scale (PHQ-2)|Questionnaire Description. Provider Search | Magellan Healthcare Employee Assistance Program Members This link will take you to the "Find my Company" page of the EAP member website. Learn more! Magellan's secure provider portal at www.MagellanProvider.com will remain available during the transition to Availity. Welcome to the Medicare Provider Enrollment, Chain, and Ownership Magellan Healthcare Organization Provider Application Assertive Community Treatment (ACT) Standards MA Bulletin Once Independence has received all required documents, we will review the information on your CAQH ProView application to ensure that it is consistent with the information provided on your Practitioner Participation Form. This information is included in a letter from Gainwell Technologies. Training & Supervision Requirements for TSS Workers FAQ Guide, February We designed it for providers who are new to Magellan; but, it may be a helpful overview for more tenured providers who want to refresh their knowledge of Magellans policies and procedures. Compliance Year in Review 2017, November Our goal is to bring providers into the network within 30 days of their initial outreach to us. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association. Yes No 12. We are happy to help. Contact Us | Magellan Health All billing for High Fidelity Wraparound services is done through CNSI. %PDF-1.5 % Any professional provider in Pennsylvania interested in participating in our network must complete and return a credentialing application kit. Provider Self Disclosure Claims Recovery Template, 2016 Compliance News PDF Independent Pharmacy Required Recredentialing Information Use the links below to find information, check member eligibility, submit and check claims view guidelines and more. Medicaid, or any Federal Health care program and will notify Magellan mmediately of any i exclusion information discovered . Below you will find links to resources such as manuals and forms. Member Newsletter: Young Adults: Its Okay to Ask for Help Spring 2021, Boletin para el miembro: Actualizacion de Servicios de Telesalud Otono 2021 Provider Application and Agreement . Boletin para el miembro:La concientizacion sobre al estres puede ayudarlo a supercar los desafios Primavera 2022 Magellan of Idaho Join our team in supporting the Idaho Department of Health and Welfare, delivering compassionate behavioral health services and making a positive impact on individuals and communities. Providers under contract with Magellan of Virginia should consult the National Provider Handbook, the Virginia Provider Handbook or contact Magellan of Virginia at 800-424-4536 or by email to: VAProviderQuestions@MagellanHealth.com or As a managed behavioral healthcare leader, we value our network providers and realize that your time is best spent with your patientsnot with administrative tasks. Psychiatric Diagnostic Evaluations (90791) Billing, July **, 2. Theres no need to resubmit information that should stay the same. Magellan takes provider fraud, waste , and abuse seriously. The Family Based Mental Health Services Program Appendix T, July 314-387-5827. A pathology provider is joining an existing participating hospital-based pathology group in a participating hospital in our five-county service area or a contiguous county (as identified above). Billing for No-Shows & Holding Members Harmless Updated Peer Support FAQs and Changes to Eligibility Criteria For more information about Magellan of Virginia, please contact Magellan of Virginia at: 800-424-4536 or, an array of behavioral health and addiction and recovery treatment services. In addition, we encourage you to review theprovider orientation presentation. An application is not accepted for processing until complete (including supporting documents). Adobe Readeris required to view PDF files. Mandatory Report Form At Magellan Rx, we are providing a smarter approach to pharmacy benefits. Not a Magellan provider yet? Peer Support Services Update MA Bulletin OMHSAS-16-12, July Once you complete steps one and two, we will send you a. Magellan Healthcare and Availity PA Code: Outpatient D&A Clinic Regulations Chapter 1223 Member Newsletter:Stress awareness can help you get through challenges Spring 2022 Legal | Privacy | Anti-fraud | Developer resources | Transparency in coverage, Language access services: Espaol | / | Lus hmoob | Vietnamese Ting Vit | | | | Franais | Deutsche | | | | Tagalog | Din Bizaad | | Italiano | | Polski | Kreyl | Portugus | | | | | | Kiswahili | Anishinaabemowin Who is required to enroll? endstream endobj startxref 2022 Magellan Health, Inc. All Rights Reserved. Skip to article content. Network Management Director Learn about best practices to improve the quality of services. ADAP services provided by Magellan Rx: Pharmacy benefit management. Member Newsletter: Helpful Resources for Families During COVID-19 Summer 2020 Providers | Magellan in Wyoming Fidelity EHR Tools and Training Questions? Providers Page | Magellan of PA If you are not already licensed, you may apply for an LDH license through the LDH Health Standards Section (HSS) via license programs available on the HSS website. Please be sure to grant Independence Credentialing permission to view/pull-in your CAQH application. Help youth and families find success, resiliency and their own voice through lifes journey. Compliance Reminders for ABA Providers, February For Emergency Situations, Always Call 911. Find out more about how this website uses cookies to enhance your browsing experience. The Year in Review, August OMHSAS Memo Regarding Public Health Emergency, May Provider Manual Title: Plan First Revision Date: 1/5/2023 Chapter VI: Utilization Review and Control Page: 1 . When the provider is joining an existing participating group; When there is a change of control or ownership of the participating providers practice, and the participating provider has complied with the terms and conditions of their Independence agreement regarding change of control or assignment, as applicable. Provider Network. Mobile Therapy Mandatory Meeting, September It is important to note that depression can occur during pregnancy as well as after the baby is born. Providers Are you a provider looking for information on Magellan plans, joining our network, or performing secure transactions related to your practice or Magellan members? Registration for Annual Compliance Forum, July Crisis Intervention Services Regulations, June The CAQH ProView online application minimizes the time it will take to complete this administrative work by eliminating the need to fill out multiple, redundant, and time-consuming forms. Magellan strives on being proactive and to use education as a preventative tool to provide our members the highest quality of care through you, the provider. [ServletException in:/WEB-INF/pages/NotLoggedIn.jsp] null' 2005-2023 Magellan Health, Inc. All Rights Reserved. Click to skip to content, You are on secondary menu. Select Contacting, Credentialing and Re-credentialing Assistance and Inquiries in the form below The site may also contain non-Medicare related information. *All forms/applications must be complete and include required supporting documents. Compliance 2015 Year in Review, November Effective 6/27/2022, a Behavioral Health Service Coordination can help members manage complex conditions related to mental health and substance use. AIDS Drug Assistance Programs (ADAP) | Magellan Rx Management Copyright 2022Health Care Service Corporation. If you have not yet signed an Independence Professional Provider Agreement but are currently participating with Magellan, you will be considered in-network for our members and will continue to be reimbursed according to Magellans reimbursement terms. ). If you are filling out paper forms, completing the credentialing process can take hours. Guidance for BSCs Attending Evaluation, May Check member eligibility, submit and check claims and find important information and more on our provider portal. If you currently participate in the Magellan network but have not signed an Independence Professional Provider Agreement, you will be considered as participating in the Independence network and will be reimbursed in accordance with the terms and conditions specified in the Magellan Professional Provider Agreement.
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