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

region/plan-specific news : Employer Plans Nationwide

EAP record review results demonstrate key opportunities for improved documentation

As part of our ongoing quality improvement efforts, Magellan must provide oversight of our network providers. To meet this requirement, we audit records annually to ensure our members receive EAP services that are consistent with recognized standards of practice and documentation.

How good documentation benefits you, the EAP provider:

  • Minimizes risk associated with complaints and lawsuits.
  • Improves quality of care.
  • Helps you remember details and see patterns.
  • Reduces the likelihood of receiving a corrective action plan when audited.

In the 2020 review, just over half (52%) of the cases we reviewed scored at benchmark (85%) or above. The overall average score was 82.4%.

Providers met or exceeded standards in the following areas...

  • Identifying workplace issues: 100%
  • Including supplemental assessment when appropriate: 98.31%
  • Documenting history, course and duration of the presenting problem: 97.59%
  • Maintaining records that are legible, organized and easy to follow: 95.18%

Where there's room for improvement:

Documenting the outcome of the case: 76.67%

When closing the case, document the outcome of the case in a way that provides a clear impression of what happened, i.e., client chose not to continue, case resolved, case referred. See the Follow-up Summary (PDF). This will help you if the client returns for counseling in the future and meets one of the EAP requirements.

Obtaining permission to contact and how to contact the client: 62.86%

Clearly document the client’s permission and preferred method to be contacted, using the Client Information Form (PDF). Both are required. While it seems obvious that you can contact the client using the phone number or email address the client provided, it is important to ask. If the client is a government employee, phone lines and email may be monitored by the agency, allowing the agency access to the client’s personal information.

Completing and signing the Statement of Understanding (SOU): 60.94%

Make sure you and each client sign the Statement of Understanding (SOU) (PDF). If you will be seeing the client virtually, you may wish to consider mailing a blank SOU form to the client, along with a self-addressed stamped envelope they can use to return the signed form. If the client indicates that they are not able to complete this step, you may read the SOU to the client and clearly indicate that the client has agreed to the SOU verbally but was unable to sign and return the form. If the client requests the form via email, be sure you inform them that email is not completely secure.

Developing a counseling plan that documents the client’s agreement (when treatment involves more than one session): 49.01%

Initiate the Counseling Plan (PDF) during the first session, based on your clinical assessment. Document the client’s participation in goals and the treatment planning process.

Completing follow-up contacts (or attempts) with the client within four weeks: 44.69%

Be sure to complete and document follow-up with the client within four weeks using the Follow-up Summary (PDF). Follow up is integral to EAP services and is one way it differs from outpatient counseling.

What you can do to help improve documentation:

  • Use the EAP clinical forms provided in the EAP supplement to the Magellan Provider Handbook on the provider website. You are welcome to add missing elements to your own forms as well.
  • Check for updates to our EAP forms regularly to see if you are using the most recent forms.
  • Access EAP registrations on MagellanProvider.com (after sign-in, select View EAP Registrations from the My Practice menu on the left). Note that EAP packets are no longer mailed to providers. 

Thank you for your ongoing commitment to providing quality care for Magellan members.

Questions about Magellan EAP quality initiatives?

You can find Magellan’s policies in the EAP supplement (PDF) to the Magellan provider handbook, including information about EAP records in Section 3, available at MagellanProvider.com/EAP.

We welcome provider questions and feedback on record reviews. Contact Amanda Grippi at 1-877-450-7281, ext. 74906, or GrippiA@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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