region/plan-specific news
: Employer Plans Nationwide
Treatment record reviews demonstrate quality of care
Accurate documentation supports quality care. Each year, Magellan conducts treatment record reviews to assess clinical documentation and identify opportunities for continuous improvement across our provider network.
2025 results exceed quality benchmarks
In 2025, the Magellan care management center serving employer plans reviewed 135 providers and cases. Providers demonstrated strong performance overall, achieving an aggregate score of 83% — well above the 70% benchmark.
Where documentation improved in 2025 (compared to 2024)
Year-over-year results show meaningful improvement across several documentation categories, reflecting providers’ continued commitment to quality of care.
Top areas of improvement:
- Consumer rights and confidentiality explained and documented (includes consent for treatment and medication) — 72% (+9.8%)
- Individualized treatment plans showing measurable and strengths-based goals (for practitioners providing therapy services only) — 84% (+4%)
- Addendum for special populations completed (with child and adolescent psychosocial information) — 86% (+18%)
- Coordination of care (with member’s primary care and other treatment providers) — 100% (+200%)
- Medication management — 100% (+43%)
- Initial evaluation (full clinical assessment of client’s presentation, continued strong performance) — 93%
Notably, providers excelled in documenting coordination of care and medication management in 2025, reaching 100% compliance, which demonstrates excellence in care collaboration and oversight.
Two areas for improvement noted
While overall documentation remains strong, audits identified two elements that will be a focus for improvement in 2026:
1. Consumer rights and confidentiality
- Include signed documentation or refusal for:
- Patient Bill of Rights
- Informed consent for medications
2. Individualized treatment plans
- Clearly document measurable goals and objectives
- Include timeframes for achievement to demonstrate clinical progress
In many cases, forms were completed but not submitted with the treatment record.
Common barriers identified
- Missing timeframes in treatment plan goals and objectives
- Consent and demographic forms completed but not included in audit submission
How to prepare for treatment record reviews
- Incorporate these elements into routine documentation workflows.
- Submit both clinical and administrative records outlined in the review request letter.
To see exactly what is reviewed, refer to the Treatment Record Review Tool (PDF), available online.
Resources to support quality documentation
- National Provider Handbook — Section 4: The Quality Partnership
www.MagellanProvider.com/handbook - Treatment Record Forms
www.MagellanProvider.com/clinicalforms - Clinical Practice Guidelines (CPGs)
www.MagellanProvider.com/clinicalguidelines
Have questions about record review?
Contact Amanda Allen at 314-387-4788 or AAllen1@MagellanHealth.com.
Thank you for your ongoing commitment to high-quality care and continuous improvement.