LBHP - Provider Common Questions

Yes, all agencies, organizations, individual professionals and group practice members must be credentialed by Magellan.

Yes, a Magellan network representative will contact providers who are currently providing services to Louisiana recipients, to discuss credentialing and contracting.

You may call a Magellan network representative at 1-800-788-4005, or send an e-mail to: LAProviderQuestions@MagellanHealth.com

Yes. The Letter of Intent (LOI) does not replace the credentialing application. You will still need to complete the appropriate credentialing application.

Please contact LAProviderQuestions@MagellanHealth.com to request a credentialing application.

In cases where there are non-licensed, Master’s level therapists providing approved services, Magellan will credential the Organization itself- rather than each individual clinician.

Yes, if you provide state-reimbursable services within Louisiana, you will need to have a contract with Magellan as of the start date of March 1, 2012. Once Magellan receives and processes your credentialing documents, they will contact you to begin the contracting process.

Magellan is in the process of finalizing the codes and services for each provider type. Reimbursement schedules with this information will be sent out with your contracting packet.

The State of Louisiana has applied for a waiver from CMS to allow for inclusion of LPC’s (and LMFT’s) to serve certain populations within this program. We anticipate final approval from CMS shortly. We are approaching this network development from the perspective that these providers will be able to participate.

Yes. Magellan will host a number of trainings for providers, with the first series beginning in December. Magellan will send additional correspondence related to the training dates and times in the near future. At the initial training, Magellan will provide an overview of their implementation plan. More detailed technical training on authorization and claims submission will occur early in 2012 to allow adequate time for transition prior to March 1st 2012

Magellan is committed to processing claims within prompt payment standards established by applicable federal or state law, or as required under our provider agreements. Magellan strives to process 99 percent of all claims within 30 days of receipt, or within the time period required by applicable state regulatory standards and customer contractual agreements. Of the 99 percent in 30 days, on average Magellan will process about 93 percent in 10 business days.

Magellan offers many options for claim submission, including on paper, through a clearinghouse, and by direct submit /electronic data interchange (EDI). Information on the direct submit process and signing up for testing is available on www.MagellanProvider.com under the “Getting Paid” section. Providers are encouraged to register for direct submit claims process as soon as possible.

Complete the credentialing application; provide a contact e-mail address and stay tuned. Magellan will provide updates as details are finalized around next steps.