Magellan of Louisiana Website

Presented by:Tracey Alfaro, Network Operations Manager

Louisiana Websitewww.MagellanofLouisiana.com

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Welcome Page

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For Providers

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For Providers “Features to Note” Training & Events

Provider Handbook

Provider Website

Providing Care

Clinical Practice Guidelines

Check Eligibility

Claims

Medical Necessity Criteria

Medication-Assisted Treatment for Substance Use Disorders

Quality Improvement and Outcomes

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Provider Training & Events Page

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For Providers “Features to Note”Provider Handbook The Magellan National Provider Handbook outlines the policies and

procedures with which providers are required to comply when serving members whose care is managed by Magellan and/or its affiliated companies.

Magellan National Provider Handbook (PDF) Magellan National Provider Handbook Appendices Organizational Provider Handbook Supplement (PDF) Louisiana Behavioral Health Partnership Handbook Supplement (coming soon)

Provider Website Visit www.MagellanHealth.com/provider for a wealth of information and online

applications pertinent to providers serving Magellan members, including: Secure online tools to submit and check claims, view authorizations,

update practice data, and more Online training, including demos of user-friendly online tools Free continuing education courses Provider discounts on computers and office supplies Medical Necessity Criteria Clinical Practice Guidelines Outcomes Library And much more!

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For Providers “Features to Note”Providing Care

This page provides information that will assist providers with providing services to Magellan members in Louisiana.

Medical Necessity Criteria (Magellan currently is finalizing the medical necessity criteria to be used with Louisiana Behavioral Health Partnership members. It will be posted soon. )

Online Training

Magellan offers a variety of online trainings to our providers, including e-courses focusing on recovery and resiliency and step-by-step user guides to help you complete various administrative online tasks, as well as demos of our online tools to help you navigate Magellan's web-based applications.

Online Trainings for Providers

Cultural Competency

Cultural Competency Resource Kit

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For Providers “Features to Note”Clinical Practice Guidelines

To deliver quality behavioral health care to our members, Magellan adopts, develops and distributes clinical guidelines based on sound scientific evidence, clinical best practices, and member needs. Magellan requires all of its providers to be familiar with these guidelines.

Check Eligibility

By signing in to the Magellan provider website with your secure username and password, you can check member eligibility and much more. (For providers who are not using Clinical Advisor.)

You may also check eligibility by calling Magellan's customer service department at the number on the back of the member's benefit card.

Note that the use of Magellan's online tool for review of eligibility does not guarantee claims payment. Payment of benefits is subject to the member's eligibility on the date service is rendered and any other contractual provisions of the plan. Payment is also subject to pre-authorization guidelines.

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For Providers “Features to Note”Claims Magellan attempts to make the claims process as easy and timely as possible by

offering instructional material, online resources, and up-to-date contact information.

In-network providers can take advantage of our• Free web-based direct data entry electronic claims submission tool• Free EDI (direct submit) option or• Use one of our contracted clearinghouses.

Find out about Magellan's electronic submission process in the Getting Paid of our provider website. There you can review online demos, browse frequently asked questions, and learn more about your payment options.

Paper Claims• Because it enhances our ability to pay you timely and accurately, we strongly

encourage you to submit claims electronically. If you are not able to submit electronically, we will accept paper claims via a CMS-1500 form.

• Paper claims must be submitted to the below address:Magellan Health ServicesPO Box 2064Maryland Heights, MO 63043

Claims Requirements• The provider handbook supplement (coming soon) will provide further

information on claims requirements.

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For Providers “Features to Note”Medication-Assisted Treatment for Substance Use Disorders

Magellan's Substance Use Solutions webpage has a variety of resources for providers working with persons with substance use disorders. Visit our Substance Use Solutions webpage for resources including program-specific descriptions, clinical tools, and materials to share with the people you serve, as well as links to a medication-assisted treatment research library, our Substance Use Clinical Practice Guidelines and Medical Necessity Criteria.

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For Providers “Features to Note”Quality Improvement and Outcomes

Magellan is committed to continuous quality improvement and outcomes management through its QI Program, which includes assessment, planning, measurement, and re-assessment of key aspects of care and services.

Outcomes

• Magellan's secure, web-based outcomes measurement system, known as Outcomes 360, features tools that help members and their caretakers assess and track progress related to their mental and physical health. You can use the assessment process and reports to enhance treatment planning for each member you serve.

• Outcomes Library

• Consumer Health Inventory (CHI)

• Consumer Health Inventory - Child version (CHI-C)

• Child and Adolescent Needs and Strengths (CANS-MH) requires training and certification for use

• Child and Adolescent Needs and Strengths Comprehensive Louisiana (CANS-LA) coming soon!

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Find a Provider

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Benefits & Services

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Non-Secure Provider Information• Provider Discounts• Magellan National Provider Handbook and Handbook Supplement for

Louisiana • Demos of Online Tools• Website User Guides• Magellan Provider Newsletter, Provider Focus • And much more!

Secure Provider Information• My Practice Information (service locations, contact information, etc.)• Credentialing and Re-credentialing Status• Check Member Eligibility (for providers not using Clinical Advisor)• View Authorizations • Submit Claims (Claims Courier – for providers not using Clinical

Advisor)• Check Claim Status • Practice Information Update Tool • And much more!

Magellan Provider Website Features

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Welcome Page

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Getting Paid

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Education

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Provider Focus Online NewsletterFound in the News & Publications Section

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When you receive your executed contract, the cover letter will give you instructions on how to sign in on the Magellan provider website for the first time

Log on to www.MagellanHealth.com/provider (accessible via www.MagellanofLouisiana.com)

Enter your User Name in the Sign In Box

• User Name = Magellan MIS #

Enter your Password

• Password = ????

Once you sign in, follow the online instructions to create a new password

You will need to assign someone as the Administrator (it can be yourself if you are a solo practitioner)

Administrative rights allow you to create a login, set an initial password and specify system rights tailored for each member of your practice

You may wish to grant access to these online tools to other staff members as you deem appropriate – an office manager, billing clerk, clinical staff, etc.

Provider Sign In (Secure Provider Information)

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My Practice