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....

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...

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...

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...

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...

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...

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'...

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...

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...

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...

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...

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...

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 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...

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...

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...

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...

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...

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...

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...

EAP registration features coming May 20

Magellan is enhancing provider website experiences to make it easier for you to complete essential tasks securely. On May 20, 2025, you’ll be able to register EAP cases and access case details and...

New episodes: Behavioral Health Matters podcast

New episodes of Magellan Behavioral Health of Pennsylvania's Behavioral Health Matters podcast are now available! In episode #9, host John Lees, Magellan’s member and family advocate for Lehigh and...

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...

New podcast episodes are here

John Lees, Magellan’s member and family advocate for Lehigh and Northampton counties, has released three new episodes of the Behavioral Health Matters podcast — featuring local and state leaders in...

CANS assessment results demonstrate Wyoming providers' impact

Wyoming’s High Fidelity Wraparound (HFWA) providers are seeing measurable progress for youth with complex needs, supported by data from the Child and Adolescent Needs and Strengths (CANS)...

Updated Wyoming 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...

Save time with Quick Claims in Availity Essentials

If you have regular patients or a repeatable set of claims, the simplified Quick Claims format may be just what you need.

Magellan celebrates provider contributions in Riverside

In March, the 10th anniversary celebration for Collaborative Psychology Group, APC, in Riverside brought together state, civic and community leaders to recognize the organization's exceptional...

What to know about your Form 1099s

We will mail your Form 1099 to the financial address on record. If you want your 1099s to go to a different address, you must update your financial address electronically via the Magellan provider...

Support youth through quality care

These three key measures play a critical role in identifying care gaps, supporting early intervention, and improving long-term outcomes for youth with behavioral health conditions.

Medical necessity criteria updates to occur in fall 2025

The 2025-2026 Magellan Care Guidelines will become effective Nov. 8, 2025. Stay tuned to our provider website for its release.

Recognizing and preventing fraud, waste, and abuse

As a valued provider in the Magellan network, you play a critical role in maintaining the integrity of healthcare services. Learn how to spot common examples of fraud, waste, and abuse.

Submitting claims for telehealth services?

Be sure to include these essential details for smooth reimbursement.

7 reasons to keep your practice data current

Starting with #1: You want to help members make informed choices about their behavioral healthcare.

Conducting routine self-audits

As a healthcare provider, it is important that your recordkeeping and claims submission processes are accurate and compliant with applicable regulations. Keep your practice compliant and avoid...

Patient safety depends on coordinating care

While the overall response rate in 2024 remained steady compared to the previous year, survey results showed a downward trend in compliance with recommended standards.

Magellan seeks to understand barriers providers face

In a recent analysis of the Magellan provider network, we’ve noticed that a significant number of practices have not attested to their information within the past quarter or submitted any claims...

The new, enhanced online EASI Form is here

Magellan is enhancing provider portal applications to make it easier for providers to complete essential tasks securely. One such task? Requesting reimbursement for EAP services. Now you have...

Magellan appoints Caroline Carney, MD, as CEO

"I am honored to have been chosen for this role leading a mission-driven organization that delivers innovative and integrated behavioral health solutions," said Dr. Carney. Meet Magellan's...

Magellan adopts new clinical practice guideline

Magellan’s clinical taskforce recently adopted an external clinical practice guideline (CPG) for substance use disorders. Guidelines serve as the evidence-based framework for practitioners’...