Provider Contracting and Re-credentialing Third Thursday Provider Call (August 20, 2015) Gail Fowler, Network Development Administrator
New Provider Contracting - In the Louisiana Behavioral Health Partnership In light of the transition of the integrated specialty behavioral health services into Medicaid managed care system, Magellan discontinued contracting and credentialing new providers as of May 31, 2015. After May 31, 2015, new providers are being directed to the Bayou Health plans. Magellan will continue to re-credential existing network providers. 2 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
Credentialing and Re-credentialing Requirements for Participating Providers In order to be a contracted provider within the LBHP network, all providers must meet standard contracting requirements with Magellan Health in Louisiana. This includes all credentialing and recredentialing requirements for the LBHP network. 3 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
Adding New Service Locations and Levels of Care Friday, August 28, 2015 is the deadline for existing contracted/credentialed providers who are interested in adding an additional location or level of care to their contract. 4 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
New Independent Assessors (IA) New providers who are interested in becoming an IA will be accepted through Friday, August 28, 2015. Contracted/credentialed providers who are interested in becoming an IA will be accepted through Wednesday, September 30, 2015. 5 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
What You Need To Know About Re-credentialing LBHP network providers are required to re-credential every three years and many providers will need to re-credential during 2015. You can review the previous credentialing date on your provider contract to see if you should anticipate correspondence from Magellan during 2015. Annual recertification through LA - Office of Behavioral Health (OBH) is also a requirement of continued provider participation in the LBHP. 6 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
What You Need To Know About Re-credentialing (Continued) Current practice data is vital to facilitating your re-credentialing in a timely manner. You can make real-time updates to practice data at www.magellanhealth.com/provider, such as: Email address Office contacts Office locations Telephone numbers Business hours Staff rosters Ensuring your provider records are complete and up to date will prevent delays such as: Applications returned for invalid address Delays in phone calls, voice messages, and emails due to out-of-date information Re-credentialing information is provided to the correct contact for your agency. 7 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
Re-credentialing Notifications When re-credentialing, please adhere closely to all timelines to ensure you remain an active provider with Magellan as the Statewide Management Organization for the LBHP. You will receive a notification letter and an application 180 days prior to your re-credentialing due date. If no response is received within 150 days of your re-credentialing date, a reminder letter will be sent. A Termination Pending letter will be sent if no application has been received 90 days prior to re-credentialing date. You will receive a Final Termination letter 2 months prior to recredentialing date if documents have not been received. 8 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
Application and Attachments Your application must be completed in its entirety. Required attachments must be provided: State Licenses including current licenses held in other states, State CDS license and Federal DEA Registration Curriculum Vitae Certificate(s) of Professional Liability Insurance History of Malpractice suits in past 5 years, regardless of whether judgments or settlements paid Explanation of any Yes Answer(s) from General Questions Section on page 8 Current Employer Identification Number (EIN) andw-9 Form or Federal Tax Deposit Coupon Education Certificate for Foreign Medical Graduates (ECFMG) (If applicable) Health Plan Agreement (If applicable) If your completed application and attachments are not received, your affiliation with the LBHP will be terminated and you will no longer receive referrals. 9 Third Thursday Provider Call (8/20/15): Treatment Record Reviews
Confidentiality Statement for Educational Presentations By receipt of this presentation, each recipient agrees that the information contained herein will be kept confidential and that the information will not be photocopied, reproduced, or distributed to or disclosed to others at any time without the prior written consent of Magellan Health, Inc. The information contained in this presentation is intended for educational purposes only and is not intended to define a standard of care or exclusive course of treatment, nor be a substitute for treatment. 10 Third Thursday Provider Call (8/20/15): Treatment Record Reviews