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MNC updates this fall

The 2024-2025 Magellan Care Guidelines will become effective later this year. Stay tuned to our provider website, MagellanProvider.com, for the release.

Featured: Featured Issue: Summer 2024
MNC updates this fall

Specialize in maternal mental health?

In support of increasing awareness of maternal mental health, Magellan gives you several options when sharing your specialties via the provider portal.

Featured: Featured Issue: Summer 2024
Specialize in maternal mental health?

Go to Availity Essentials for claims and more

With Magellan's Claims Courier set to retire in the coming weeks, Availity Essentials' simplified claims functions could be just what you need. (Plus, Availity Essentials gives you access to claims...

Featured: Featured Issue: Spring 2026
Go to Availity Essentials for claims and more

You are not alone on complex cases

Magellan offers timely case management and peer support When you determine that a patient you’re treating has a particularly challenging set of needs, which can include behavioral health symptoms...

You are not alone on complex cases

Outpatient provider dashboard gets makeover

Beginning in 2025, Magellan’s* network providers in California that qualify for an outpatient dashboard will notice several changes aimed at better measuring quality metrics for our provider...

Outpatient provider dashboard gets makeover

Refer Sharp Health Plan members to in-network labs

Laboratory expenses are one of the biggest contributors to a patient’s healthcare costs. That’s why Magellan* and our health plan client, Sharp Health Plan, ask you to refer members to an...

Refer Sharp Health Plan members to in-network labs

Ria Health offers alcohol use disorder treatment

Looking to help commercial Blue Shield of California or Sharp Health Plan members navigate their options for managing a primary alcohol use disorder diagnosis? Ria Health is a virtual alcohol...

Ria Health offers alcohol use disorder treatment

Plan-specific material revised

Be sure to visit the Plan-Specific Information page on our provider website for provider materials – such as handbook supplements and quick reference guides – that are specific to regions where you...

Plan-specific material revised

Devoted Health members are in network

As of Jan. 1, 2025, Magellan will manage behavioral health benefits for Devoted Health Medicare Advantage members in additional states and counties. States with Devoted Health plan members include...

Devoted Health members are in network

TX Medicaid: Are your locations correct in PEMS?

Keeping your practice information up to date is essential to ensuring appropriate referrals, appointment availability and accurate and timely claims processing. This is why, in addition to...

TX Medicaid: Are your locations correct in PEMS?

EAP handbook supplement updated for 2025

In addition to a revised Magellan National Provider Handbook, you’ll find the updated handbook supplement for Employee Assistance Program (EAP) providers – in effect for 2025 – on our provider...

EAP handbook supplement updated for 2025

Your efforts are vital to members' care and safety

How coordinating with other providers offers best-practice care to Magellan members An essential element in the quality care you provide to Magellan members is coordinating services among members’...

Your efforts are vital to members' care and safety

Collaboration helps improve quality of care

Magellan of Louisiana collaborates with providers to investigate and jointly address quality-of-care concerns. The Quality of Care Concern (QOCC) Work Group, under the leadership of Magellan’s...

Collaboration helps improve quality of care

Updated Louisiana CSoC handbook supplement online

The updated Louisiana Coordinated System of Care supplement (PDF) is available online at MagellanProvider.com. Contracted providers must follow the policies and procedures outlined in handbook...

Updated Louisiana CSoC handbook supplement online

Provider Town Hall recording from Sept. 17 now available

Magellan Behavioral Health of Pennsylvania wishes to thank everyone who participated in our most recent virtual Provider Town Hall on Sept 17, 2024. If you were unable to attend or wish to refer to...

Provider Town Hall recording from Sept. 17 now available

Updated PA HealthChoices supplement online

The updated Pennsylvania HealthChoices supplement (PDF) is available online at MagellanProvider.com. Contracted providers must follow the policies and procedures outlined in handbook supplements as...

Updated PA HealthChoices supplement online

Podcast features in-depth conversation with RCPA president

A new episode of Magellan Behavioral Health of Pennsylvania’s Behavioral Health Matters podcast is now available! In this episode (#7), host John Lees, Magellan’s member and family advocate for...

Podcast features in-depth conversation with RCPA president

Updated WY CME supplement online

The updated Wyoming supplement (PDF) is available online at MagellanProvider.com. Contracted providers must follow the policies and procedures outlined in handbook supplements as well as those in...

Updated WY CME supplement online

Provider Town Hall recording from Dec. 17 now available

Provider Town Hall recording from Dec. 17 now available Magellan Behavioral Health of Pennsylvania wishes to thank everyone who participated in our most recent virtual Provider Town Hall on Dec....

Provider Town Hall recording from Dec. 17 now available

Reporting self-audits in the Pennsylvania HealthChoices program

Reporting self-audits in the Pennsylvania HealthChoices program The feature article “Routine Self-Audits: A Guide for Providers” applies in the Pennsylvania HealthChoices program, except for how...

Reporting self-audits in the Pennsylvania HealthChoices program

Starting the conversation about MAT

Starting the conversation about medication-assisted treatment for alcohol Magellan Behavioral Health of Pennsylvania and our county partners believe we need to change the mindset that the only way...

Starting the conversation about MAT

Supporting those living with disabilities

Tune into the latest podcast on resources to support living with disabilities A new episode of Magellan Behavioral Health of Pennsylvania’s Behavioral Health Matters podcast is now available for...

Supporting those living with disabilities

Promoting suicide awareness

As a mental/behavioral health provider, you’re likely all too aware that suicide and substance use disorders are a serious public health concern. Help prevent suicide by promoting awareness with...

Featured: Featured Issue: Summer 2024
Promoting suicide awareness

Magellan of PA earns NCQA Health Equity accreditation

Magellan Behavioral Health of Pennsylvania earns NCQA Health Equity accreditation As shared in a recent Magellan press release, Magellan Behavioral Health of Pennsylvania, Inc. has earned a...

Featured: Featured Issue: Summer 2024
Magellan of PA earns NCQA Health Equity accreditation

Screening for risk with Neuroflow

NeuroFlow uses a type of artificial intelligence (AI) known as natural language processing to analyze members’ journal entries and alert providers about members who may be in urgent need or...

Featured: Featured Issue: Summer 2024
Screening for risk with Neuroflow

Practitioners: Medical recordkeeping required

In facility settings, practitioners who bill for their services using their own tax identification number as a separate entity are essentially operating as independent entities within the facility.

Featured: Featured Issue: Summer 2024
Practitioners: Medical recordkeeping required

Podcast: Navigating trauma-informed care

"I think the idea of trauma awareness really helps us as an industry to be less judgmental and more able to make empathic connections," said Magellan's Steven Pratt, MD.

Featured: Featured Issue: Summer 2024
Podcast: Navigating trauma-informed care

Outpatient provider bonuses paid in 2023

Maximize your bonus potential in 2024 Each quarter, Magellan* sends all high-volume outpatient behavioral health providers in California personalized practice dashboards, which display the...

Outpatient provider bonuses paid in 2023

BCBS TX: ABA criteria to change for Blue Advantage Nov. 2

Effective Nov. 2, 2024, the medical necessity criteria for applied behavior analysis for all Blue Cross and Blue Shield of Texas Blue Advantage members will change to BCBS TX Applied Behavior...

BCBS TX: ABA criteria to change for Blue Advantage Nov. 2

Beware of false requests for medical records or PH

Magellan recently learned that individuals posing as employees of other managed care organizations have sent false requests for information via email and texting to fraudulently obtain patients'...

Featured: Featured Issue: Spring 2025
Beware of false requests for medical records or PH

MNC updates this fall

The 2025-2026 Magellan Care Guidelines will become effective later this year. Stay tuned to our provider website, MagellanProvider.com, for the release. The 2024-2025 Magellan Care Guidelines will...

Featured: Featured Issue: Spring 2025
MNC updates this fall

5 tips for billing psychological testing

Psychological testing is a critical component of patient assessment and treatment planning. However, accurate billing and compliance with applicable plan, federal and state requirements are...

Featured: Featured Issue: Spring 2025
5 tips for billing psychological testing

Supporting mental health at every age

Resources to share with patients, family, friends and colleagues From childhood to older adulthood, our mental health needs evolve. Understanding and prioritizing what matters most at each stage...

Featured: Featured Issue: Spring 2025
Supporting mental health at every age

TX Medicaid: Maternal mental health matters

Let Magellan know! Magellan is expanding our network of providers who support maternal mental health. If you specialize in postpartum and reproductive mental health, we invite you to share this...

TX Medicaid: Maternal mental health matters

Latest podcast explores PTSD

A new episode of Magellan Behavioral Health of Pennsylvania's Behavioral Health Matters podcast is now available! In this episode (#6), host John Lees, Magellan’s member and family advocate for...

Latest podcast explores PTSD

Life lessons help with recovery

Magellan Behavioral Health of Pennsylvania and our county partners support recovery efforts in our communities. Magellan employee authors op-ed to increase awareness To help reduce stigma around...

Life lessons help with recovery

Agency expands on its HFWA mission

Wraparound Solutions in Wyoming, led by Diva Bermudez, is a beacon of support for families facing various challenges. Founded in 2019, the Wraparound agency goes beyond traditional High Fidelity...

Agency expands on its HFWA mission

Battling hunger in Wyoming

The High Fidelity Wraparound Program in Wyoming is actively engaged in First Lady Jennie Gordon's Wyoming Hunger Initiative. Launched in October 2019, this initiative is dedicated to eradicating...

Battling hunger in Wyoming

Collaborative Connections Conference held in June

The Collaborative Connections Conference, a joint effort of Magellan of Wyoming and the Wyoming Department of Health and Healthcare Financing, was a huge success! Held in Casper, Wyoming, June...

Collaborative Connections Conference held in June

What members want

Meeting members’ needs is the most important component of a positive member experience, but it's not enough to guarantee high member satisfaction.

Featured: Featured Issue: Summer 2024
What members want
MARCOM Awards

Provider Focus has won the MARCOM Gold Award in 2024, 2023, 2022, and 2021