CV's required for Magellan Re-Credentialing

In addition to an up to date file with CAQH (Council for Affordable Quality Healthcare), Magellan is also requiring providers submit a detailed CV for completing the credentialing/re-credentialing process.  Magellan feels the information contained in your CV will assist them in matching your skills with the needs of their members.  For more information visit www.magellanprovider.com and review the latest provider focus newsletter.  For CAQH file updates visit https://upd.caqh.org/oas/

Great Lakes Health Plan has a new behavioral health vendor

UBH has become the new behavioral healthcare vendor and affiliate company for GLHP effective 1/1/2011.  GLHP began sending letters out to providers in December inviting them to participate in the UBH network.  Courtesy par status with UBH will be extended to all GLHP providers until 3/31/2011.  Providers can contact customer service at 800.903.5253

Harvard Pilgrim Providers

Outpatient authorizations are no longer required for patients seeing an in network provider. For those that aren't aware, behavioral health services are managed by United Behavioral Health.

MHN's New Outpatient Management Process

Starting 10/15/2010, MHN eliminated the re authorization process and introduced a new registration process.  All MHN providers seeing clients on an outpatient basis have had to deal with those re authorization "kits".  These kits were used for requesting more outpatient authorized sessions.  Well, no more!  MHN has done away with the kits/outpatient treatment request forms.  Providers will now be required to only notify MHN that a patient is in treatment.  No forms will be mailed to provider.  The client will be able to utilize all sessions available on their plan without requiring an authorization.

Retrieving those Value Options EOB's

By now I'm sure you are aware Value Options has discontinued mailing paper provider summary vouchers(eob's).  Unfortunately there are still providers out there that have no idea how they can retrieve the eob's in order to reconcile patient accounts.  You can call 866.409.5958 to have those printed eob's faxed to you.  The process is very simple.  Just follow the prompts and in no time you'll have the information you need.  You can also go online to www.valueoptions.com and register on Provider Connect.

Changes at Ceridian for EAP reimbursement

I am late with this information and do apologize.  I wanted to make sure I had all correct information before putting it out for everyone.  Beginning January 3, 2011 Ceridian Lifeworks and Military OneSource transitioned to a new system for processing EAP claims.  Providers were only informed in December of 2010 of the upcoming changes.  Ceridian now requires providers to use their new intake assessment, session/progress notes and case closure forms for all Lifeworks and Military OneSource clients.  The session/progress notes form doubles as an invoice and is required to be submitted within (3) days of the client session.  Ceridian mailed out copies of the new forms for providers to submit invoices via fax or mail.  Providers can also use the Web portal on Ceridian's website to submit the required forms.  You may contact Ceridian directly with any questions at 800.367.3920 or email provider services at pnsinquiries@ceridian.com.