Magellan Health

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Provider Communications

Provider Focus

Magellan is committed to keeping you informed on the fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the transition from ICD-9-CM (International Classification of Diseases, 9th Edition, Clinical Modifications) diagnosis codes to ICD-10-CM diagnosis codes.  Click Here for information on these topics.


To access Magellan's Provider Focus, our e-newsletter for providers, go to www.magellanproviderfocus.com.  You'll find current articles and information relating to Magellan and our local service centers. You'll also find past issues of Provider Focus. Check back as a new issue of our newsletter is released each quarter.

 

Provider Resources

Information on Behavioral Specialist License:

DPW Implementation Plan - General Stakeholder Wed-Ex: January 29, 2014

BSL Tracking Webinar

Behavioral Specialist Licensure - DPW Implementation Plan - General Stackholder Web-Ex: April 17, 2013

Announcement: WebEx Link & April Application

Responses to Questions Raised on the April 17, 2013 Web Ex Training for Behavioral Specialist License (BSL)

Behavior Specialist Licensing Update - Provider Announcement - March 6, 2013

Bureau of Autism Services Behavior Specialist License - Current Status as of February 21, 2013

Application for Behavior Specialist License

Behavioral Specialist License Application Process

Behavior Specialist Frequently Asked Questions

Content Area Descriptions for Licensure 

Commonwealth of Pennsylvania Department of Public Welfare Letter - Behavior Specialist

 

Provider Screening Tools

Magellan Behavioral Health of Pennsylvania launched its screening programs to target individuals who may have co-occurring mental health and substance use disorders, as well as a brief screening tool for depression. Magellan chose the following screening tools:

The Global Appraisal of Individual Needs-Short Screener (GAIN-SS) | Short Screener Description

The Patient Health Questionnaire two-item scale (PHQ-2) | Questionnaire Description

The GAIN-SS is a brief five minute instrument designed to quickly and accurately screen general populations of both adults and adolescents to detect psychiatric disorders, substance use disorders, or crime and violence problems. The screener helps identify those who would benefit from further assessment or referral for these issues, and also rules out those who do not have a behavioral health disorder.

The PHQ-2 consists of the first two items from the longer Patient Health Questionnaire-9, which consists of nine items that align with the DSM criteria for major depression. The PHQ-2 inquires about the frequency of depressed mood and loss of pleasure or interest over the past 2 weeks. Its purpose is not to establish a final diagnosis but to screen for depression as an initial approach. A PHQ-2 score ranges from 0-6, with recommendations for further screening with a PHQ-9 for anyone scoring a 3 and above.

Screening tool access:

www.gaincc.org

www.phqscreeners.com

The screening tools will be of use to identify any member suspected of possibly having a depressive disorder and/or individuals with a mental illness who could also potentially have a substance use disorder. It will be recommended that these tools be utilized for every potential candidate on initial evaluation and at least on a quarterly basis.

Webinar access:

Webinar - Screening Tools

Magellan created a provider webinar to teach providers about Magellan's screening tool program and how to utilize the tools selected. The webinar training covered the following:

  • Purpose of the program
  • Identify the targeted population for the tools
  • Descriptions of the tools selected
  • Benefits of using the screening tools

  

Metabolic Syndrome Materials

A Practitioner's Resource Guide: Helping Families to Support their LGBT Children


Provider Notifications

DHS has prepared the attached training/informational guides to help providers, business and community partners in the transition to the new HealthChoices Expansion Program.  The following were added to the HealthChoicesPA.com website under the Provider Information tab:

 

Compliance News

Magellan Behavioral Health of Pennsylvania, Inc. (Magellan) strives on being proactive and using education as a preventative tool to provide our members the highest quality of care through you, the provider. The Quality Improvement and Compliance Departments at Magellan have committed to sending monthly e-mails to targeted providers on a Compliance related subject.  Click Here to view our Monthly Compliance Alerts.
 


CPT Code Changes

The American Medical Association (AMA) issued major changes to behavioral health CPT codes for dates of service on and after January 1, 2013, impacting both payors and providers.  This affects all provider types (psychiatrists, psychologists, clinical social workers, etc.) that provide CPT professional services in all states.

Click here to view the 2013 CPT Code Changes, Background and Frequently Asked Questions for Pennsylvania HealthChoices Providers.

Click here to view Magellan's 2013 CPT Code Crosswalk for Pennsylvania HealthChoices Providers.



Training/Webinar Alerts

Magellan Clinical Practice Guidelines for Assessment and Treatment of Autism Spectrum Disorders

 

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Recovery & Resiliency

Learn about Magellan’s Integrated Health Home (IHH) Initiative in #B4Stage4 Video

E-Learning Center
Magellan's E-Learning Center offers educational information, videos and professional learning opportunities about peer support, whole health and wellness.

Links

Addiction Technology Transfer Center Network

Choose My Plate

COMPASS: CLICK. APPLY. BENEFIT

Eat Right

HealthChoicesPA

MedlinePlus

Million Hearts

NAMI PA

National Council for Community Behavioral Healthcare

National Diabetes Education Program

NIH Senior Health

Pennsylvania Department of Health

Pennsylvania Department of Human Services

Philabundance

PROACT

SAMHSA's Wellness Efforts 

Pharmacy Links:

AmeriHealth Caritas

Gateway Health

United Healthcare

Aetna Better Health

UPMC Health Plan

Health Partners

Keystone First

Contact Information

Member Services:
Bucks County: 877-769-9784
Delaware County: 888-207-2911
Lehigh County: 866-238-2311
Montgomery County: 877-769-9782
Northampton County: 866-238-2312

Provider Services:
Bucks/Montgomery: 877-769-9779
Delaware County: 800-686-1356
Lehigh/Northampton: 866-780-3368

Fraud & Abuse: 800-755-0850

For emergency situations always call 911

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