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

region/plan-specific news : Employer Plans Nationwide

Treatment record reviews demonstrate quality of care

We’re committed to quality care and look to you, our network providers, to embody this in your practices. To this end, Magellan conducts treatment record reviews (TRR).

In 2019, the Magellan care management center serving employer plans reviewed 84 individual providers and 84 separate cases. The results largely indicated that, in most cases, providers met high quality standards in their treatment record documentation. The aggregate score for all the cases reviewed was 84.2%, which far exceeded the goal of 70%.

Quality improvement

However, a few elements stood out as areas for improvement. They fell primarily into the categories of consumer rights and confidentiality and coordination of care, with scores in the mid-forty percentages.

  • Consumer rights and confidentiality (includes consent for treatment and medication) – 45.6%
  • Coordination of care (with member’s primary care and other treatment providers) – 46.2%
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We strongly encourage you to incorporate these areas into your medical record processes to demonstrate your efforts and attention to ensuring quality, whole-person member care and education.

Documentation categories meeting target in 2019

  • General demographic information – 88.6%
  • Initial clinical evaluation (full clinical assessment of client’s presentation) – 92.7%
  • Individualized treatment plan (for practitioners providing therapy services only) – 79.7%
  • Ongoing clinical treatment and progress – 87%
  • Medication management (for medication prescribers only) – 77.4%

Quality aids to support you:

  • Treatment record documentation templates on the clinical forms page of our provider website will assist you in meeting Magellan’s documentation standards for specific employer plans. These include initial evaluation, progress note, treatment consent, medication consent and coordination of care forms.
  • Treatment record review tool, also available on the clinical forms page, while not required in the member's file, is used by Magellan reviewers when evaluating treatment records and will let you know what we look for.
  • Section 4: The Quality Partnership in Magellan’s provider handbook includes information about treatment record and clinical practice guidelines review standards.

Questions about record reviews?

Contact Lorraine Langdon-Hull at (314) 387-4892 or LGLangdon-Hull@MagellanHealth.com.

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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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