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 2021, the Magellan care management center serving employer plans reviewed 298 separate providers and 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 86.2%, which far exceeded the goal of 70%.
Two areas for improvement
However, two elements stood out as areas for improvement:
- Consumer rights and confidentiality (includes consent for treatment and medication) – 51.4%
- Coordination of care (with member’s primary care and other treatment providers) – 30.7%
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.
Five documentation categories on target
- General demographic information – 84.6%
- Initial clinical evaluation (full clinical assessment of client’s presentation) – 87.1%
- Individualized treatment plan (for practitioners providing therapy services only) – 72.4%
- Ongoing clinical treatment and progress – 83.6%
- Medication management (for medication prescribers only) – 79.5%
Resources 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.
- The treatment record review tool is also available on the clinical forms page. Magellan reviewers use this tool when evaluating treatment records. While it is not required to be in the member's file, it will let you know what we look for.
- Section 4: The Quality Partnership in Magellan’s provider handbook (PDF) 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.