IPSF Behavioral Health Practice

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OCTOBER 1, 2009
IPSF Behavioral Health Practice Management
Workshop
Presentation by DENNIS PETERSEN, Ops. Director,
Magellan Health Services GLORIA SCHOLL, Sr.
Contract Mgr., Magellan Health Services CHRISTINE
BRYANT, Admin. Manager, Magellan Health Services
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Whats New at Magellan

• and how it affects you.

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Whats New At Magellan?

• New Iowa Plan Contract 1/1/2010
• Going Green Initiatives

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New Iowa Plan Contract

• Effective 01/01/2010

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Changes to the Iowa Plan that Affect You

• Provide services to enrollees aged 65 and older
  effective July 1, 2010.
• Iowa-specific Website.
• Claims turn-around times.

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65 Population

• Start July 1, 2010.
• In 2008, the Iowa Medicaid program
  had approximately 25,000 members
  aged 65 and older.
• Partner with primary care for mental
  health/substance abuse referrals.
• Transition of care during June 2010 to ensure all
  current services/providers are continued.

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New Web Site www.MagellanofIowa.com

• Iowa Specific
• For Consumers
• Information on accessing treatment.
• Provider directory or provider search function
  easy to navigate.
• For Providers
• Authorization forms
• Appeal Process
• Check claim status
• Check eligibility
• Provider manual

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For Consumers

• Member Handbook
• Available Services
• Provider Search

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For Providers

• Provider Manual
• Appeals Process
• Check Eligibility
• Claims
• Forms

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New Claims Turn-Around Times

• 90 processed within 12 calendar days
• 99 processed within 30 calendar days
• 100 processed within 90 days
• Note Departments intend to adopt ICD-10 codes
  in October 2011 as proposed by CMS. Magellan
  will adopt this as well.

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Magellan is Going Green!

• How will this affect you?

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Appeals Process

• As part of Magellan's ongoing efforts to reduce
  and eventually eliminate all paper medical
  records files, we encourage Iowa Plan providers
  to submit appeals electronically.
• Email DSMAppeals_at_magellanhealth.com
• Fax [phone]

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Authorization Letters

• Stop receiving paper copies.
• View on-line via our secure Web site.
• Sign up on-line at www.MagellanProvider.com.
• For assistance, call Provider Services at
  1-800-788-4005.

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Electronic Claim Submission - Whats in it for
you?

• Improved Efficiency
• No paper claims. No envelopes. No stamps.
• Prompt confirmation of receipt or incomplete
  claim.
• Faster Reimbursement cut out the mailman
• Improved Quality
• Up-front electronic review ensures higher
  percentage of clean claims.
• Secure process with encryption keys, passwords,
  etc.

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Electronic Claim Submission

• Claims Courier - Magellans Web Option
• For smaller-volume submitters.
• Its free!
• Web-based, just go to www.MagellanProvider.com.
• Manually key info like you would a CMS-1500 form.
• Info is saved and can be copied for new dates of
  service.
• Clearinghouse
• For larger volume submitters.
• Magellan works with seven preferred
  clearinghouses which accept both professional
  (CMS 1500) and institutional (UB-04) claims.
• Commonly tie in with practice management
  software.
• Check with each clearinghouse for their fees.
• Direct Submission to Magellan
• For medium to high volume submitters.
• Its free!
• Send HIPAA compliant transactions (claims)
  directly to Magellan using your existing software.

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Electronic Claims - Did you know?

• You can now submit electronically
• Claims with Coordination of Benefits
• Enter primary insurance information.
• Corrected Claims
• Be sure to indicate corrected claim.
• No Shows New Codes
• H0046 U1 first no show
• H0046 U2 second no show

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Give us your email address!

• Most of our provider notices and communications
  are now being sent electronically. Register your
  billing contact email address with us today so
  you dont miss out on any important information!
• Send your email address to CLDillinger_at_magellanhe
  alth.com.

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Resources on the Web to Help You
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Resources on the Web
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On-line Training Web User Guides
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On-Line Demos Claims and Electronic Transactions
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Contact Information

• Customer Service - claims issues, eligibility,
  etc.
• Ph. 800-638-8820, Fax [phone]
• Manager Christine Bryant ext. 85009 or
  CRBryant_at_magellanhealth.com.
• Contracting contract renewal/provider
  credentialing, rates, etc.
• Ph. 800-638-8820, Fax [phone]
• Manager Gloria Scholl ext. 85048 or
  GJScholl_at_magellanhealth.com.
• EDI Technical Support web site assistance,
  electronic claim submission issues, technical
  assistance, etc.
• Ph. 800-450-7281 ext. 75890 or
  EDISupport_at_magellanhealth.com.

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Any Questions?