2024 national handbook and supplements now online
We’ve recently updated the Magellan National Provider Handbook and several of the handbook supplements that pertain to EAP providers and to serving specific plans and/or states. These important resources are located on our provider website at www.MagellanProvider.com/handbook.
Highlights of the Magellan National Provider Handbook revisions for 2024 include:
Section 1: Introduction
- Reference to a redesigned product offering known as Magellan Total Wellbeing, which allows for proactive member identification and access to behavioral health services through high-tech and high-touch experiences.
- Emphasis on the integration of Recovery and Resiliency principles into how our programs and services are developed and implemented.
Section 2: Behavioral Health Network
- Credentialing and Recredentialing section: Update to the branding of the universal credentialing application, CAQH® Provider Data Portal, known previously as ProView.
- Updating Practice Information: Addition of a policy requiring providers to contact their Magellan field network coordinator (or area contract manager for facilities/organizations) if they will be providing services in a new state or via the telehealth (video conferencing) modality.
Section 3: The Role of the Provider and Magellan
- Member Access to Care section: Update to the presentation of Magellan’s access to care standards for providers and addition of new CMS access timeliness standards for serving Medicare Advantage members.
- Recovery Support Navigation section: Addition of Family Support Navigation services to promote greater family participation in the treatment process.
Section 4: The Quality Partnership
- Prevention/Screening Programs section: Addition of a diverse new list of screening programs that Magellan administers through its care management centers.
- Confidentiality section: Emphasis that providers should report to Magellan any inadvertent access or disclosure of member informationreceived in any way including email, regular mail, fax, or via the Magellan provider portal. Report it to our Compliance Hotline at 1-800-915-2108 or Compliance@MagellanHealth.com.
- Fraud, Waste, Abuse and Overpayment section: Inclusion of a new summary of “What to expect during pre-payment review” should a provider be placed on a Magellan pre-payment claim review for any reason.
Section 6: Medicare Advantage Beneficiaries
- This section underwent a title and content renaming with the addition of the word “Advantage.” We did this to clarify that we serve organized plans such as HMOs, PPOs and Special Needs Plans that are managed by private healthcare companies and approved by Medicare. These differ from Original Medicare. The section also includes the new CMS access-to-care standards for Medicare Advantage members.