Updated California, BSC and CalOptima supplements
The revised California, Blue Shield of California (BSC) and CalOptima provider handbook supplements and related appendices are now online on Magellan’s* provider website.
Contracted providers must follow the policies and procedures outlined in handbook supplements, as well as those in the Magellan National Provider Handbook.
We encourage providers to review the handbook and supplements on a regular basis; however, you'll want to take special note of the following sections with updates:
- California supplement—updates to Section 3: Preauthorization Requirement for Outpatient Care; Member Complaints and Appeals; Appointment Access Standards; Telephone Access Standards; Practice Data; Section 4: Quality Assurance; Provider Input; Section 5: Claims Filing and Disputes
- Updates to California appendices F (member grievance forms), I (language assistance), K (patient financial responsibility)
- Eliminated appendix J, since content was incorporated into Section 3: Before Services Begin (Precertification) of the supplement
- BSC supplement—updates to Section 1: Introduction and Section 3: Member’s Access to Care
- CalOptima supplement—update to Section 1: Introduction (Medical Necessity Criteria) and Section 3: Member Complaints and Appeals; and Appendix: Professional Provider Selection Criteria
You can find the updated supplements by choosing State-, Plan- and EAP-Specific Information under our News & Publications menu item. The updated California supplement to the national handbook is under the State-Specific heading, and the BSC and CalOptima handbook supplements are under the Plan-Specific heading.
*In California, Magellan does business as Human Affairs International of California and Magellan Health Services of California, Inc. - Employer Services.