Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers

region/plan-specific news : California

Medication management AND therapy? Kaiser Permanente members need two separate authorizations

Recently, Magellan Healthcare* has noticed some confusion in the network around providing services related to Kaiser Permanente members.

Just a reminder:

For Kaiser Permanente members, when medication management is authorized, therapy services are not included and require a separate authorization.

If you do not have two authorizations yet submit claims for both services, the claim for the unauthorized service will deny. You may not bill Kaiser Permanente members for the portion of the claim that denies for lack of authorization.

More information:

  • Refer to the Quick Reference Guide (PDF) posted to the Kaiser Permanente page of our provider website for more details about authorization, timely appointment access, cost share and claims.
  • Contact Magellan directly at 1-800-327-5479 for authorization of medication management and/or outpatient therapy services. Contact Kaiser Permanente for higher levels of care.

Thank you for supporting Kaiser Permanente members!

 

*In California, Magellan does business as Human Affairs International of California, Inc. and/or Magellan Health Services of California, Inc. – Employer Services

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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