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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

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

Upcoming changes to Magellan benefit administration, Jan. 1

In January 2026, Magellan Healthcare* will begin to phase out behavioral health benefit administration for several health plans. We understand the importance of continuity of care and provider...

Upcoming changes to Magellan benefit administration, Jan. 1

Treatment record reviews finish strong

The Human Affairs International of California (HAI-CA)* care management center recently completed collating the results of its annual member treatment record review, which included clinical...

Treatment record reviews finish strong

Timely follow-up appointments help patient outcomes

Key dates to know when scheduling FUH, FUM, and FUA appointments at year's end You’re likely already aware that meeting HEDIS standards* can help providers align their practices with evidence-based...

Timely follow-up appointments help patient outcomes

Texas facilities: Requesting an in-lieu of service

Magellan* authorizes intensive outpatient program (IOP), partial hospitalization program (PHP), coordinated specialty care (CSC), and institution of mental disease (IMD) services as an in-lieu-of...

Texas facilities: Requesting an in-lieu of service

Texas Medicaid requires enrollment revalidation

The Texas Health and Human Services Commission (HHSC) has asked managed care organizations, including Magellan,* to help providers complete Medicaid enrollment revalidation. Why this matters If you...

Texas Medicaid requires enrollment revalidation

Providers participate in treatment record review

Magellan compiles annual results of its provider treatment record review process applicable to the Magellan center serving commercial health plans in the states other than California. As reflected...

Providers participate in treatment record review

Plan-specific materials revised

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

Plan-specific materials revised

QI program evaluation reflects accomplishments

The Magellan center serving commercial health plans in states other than California conducted a comprehensive evaluation of its quality improvement (QI) program covering the full year 2024. For the...

QI program evaluation reflects accomplishments

Upcoming changes to Magellan benefit administration, Jan. 1

In January 2026, Magellan Healthcare will begin to phase out behavioral health benefit administration for several health plans. We understand the importance of continuity of care and provider...

Upcoming changes to Magellan benefit administration, Jan. 1

EAP handbook supplement updated for 2026

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 2026 — on our provider...

EAP handbook supplement updated for 2026

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
MARCOM Awards

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