Measuring clinical outcomes is an important component of delivering high-quality care and is useful in engaging members in treatment planning.

Magellan uses assessment tools to monitor and improve the safety and effectiveness of services provided to members. And we encourage you to use SAMHSA or other national quality endorsed screening and assessment tools as well.

The Child and Adolescent Needs and Strengths (CANS) is a tool available securely via this website, to providers serving members in certain public programs.

Life's journey made easier

Healthwise

Looking for helpful resources to share with Magellan members you’re serving? Magellan offers you and your clients access to Healthwise, an online library of resources. Conduct a keyword search or browse topics today. For a user-friendly print version of a topic or webpage to share with the member, simply click the Advanced Printing Options button at the bottom of the page.

Program-specific sites

Commercial or employer plans: Let Magellan members know they have access to a wealth of program and educational information, at no additional cost, through their program-specific Magellan website (varies depending on the member's health plan or employer). 

Public sector (e.g., state-sponsored or government-funded) programs: Members may visit Magellan's websites for their particular state -- Louisiana, Pennsylvania, Virginia and Wyoming. Select "For Members" from the menu ("Youth and Families" in Wyoming).

As a Magellan provider, the services that you offer our members are subject to both federal and state laws (PDF) and contract requirements designed to prevent fraud, waste and abuse in government programs (such as Medicare and Medicaid) and private insurance. You can find definitions, examples and ways to prevent fraud in Magellan’s fraud, waste and abuse FAQs.

The most serious violation in this category is healthcare fraud, which is the intentional deception or misrepresentation made by an individual, knowing that the misrepresentation could result in some unauthorized benefit to them or to others. The most common kind of healthcare fraud involves false statements or deliberate omission of information that is critical in the determination of authorization and payment for services. Healthcare fraud can result in significant monetary liabilities and, in some cases, subject the perpetrator to criminal prosecution.

We have a comprehensive compliance program in place, including policies and procedures to address the prevention of fraud, waste and abuse. Magellan, in conjunction with appropriate government agencies, actively pursues all suspected cases of fraud, waste and abuse.

If you think you have detected an instance of either healthcare fraud or medical identity theft, please contact our Special Investigations Unit (SIU) through our 24-hour Fraud Hotline at 1-800-755-0850 or by email at SIU@MagellanHealth.com.

Magellan supports culturally sensitive care that respects the member’s cultural beliefs, practices and language preferences.

As you collaborate with us, we will ask you to employ current best practices in providing culturally competent care for our members. The following external resources will aid you (and us) in developing realistic and incremental organizational cultural competence plans.

• National CLAS Standards

• Georgetown University National Center for Cultural Competence

• National Center for Cultural Competence Self-assessments

• SAMHSA Cultural Competency Training and Resources 

Locate our policies related to cultural competency in section 4 on page 49 of the Magellan National Provider Handbook.

Now is the time...Deliver your same high-quality professional services virtually

Treat members at a time that works, and a place that's safe and secure for both of you. Through telehealth, you can have real‐time, two‐way communication via secure online virtual sessions. 

Telehealth attestation

If you offer virtual sessions, let us know! Complete and submit this brief telehealth attestation so members looking for a telehealth provider can find you in our directory. Note: this form requires your MIS number; if you do not know your MIS number, call us at 1-800-788-4005 to request it.

Telehealth 101 webinar

Sign in to this website with your username and password then, from the Education menu, select Telehealth to access the link to our free webinar, "Telehealth 101: What You Need to Know & How to Get Started." 

For more information

• Review our frequently asked questions (PDF).

• Refer to the Telehealth Services page in Section 3 of our provider handbook (PDF).

• Contact your Magellan network field representative or the national Provider Services Line at 1-800-788-4005 to learn more.

Additional resources

• American Telemedicine Association

• Center for Connected Health Policy: the National Telehealth Policy Resource Center

• American Psychiatric Association Telepsychiatry Toolkit

• Relias telehealth course series

• AMA Steps Forward Module: Adopting Telemedicine

• SOAP notes guide (PDF)

• 10 steps to getting started as a telehealth provider (PDF)

Telehealth billing

After you complete your telehealth attestation, you can begin delivering care via telehealth for members for whom it is a covered benefit.

• Telehealth payable services - commerical plans (PDF)

• Telehealth payable services - Medicare plans (PDF)

• Telehealth billing instructions (PDF)

  • California telehealth billing (PDF)

• Organizations/facilities: Use license-level modifiers (PDF)

Note: Coverage for codes is subject to the provisions and limitations of the subscriber’s benefit plan including authorization requirements. Nothing in these documents should be construed as altering subscriber’s benefits.