If your mental health clinic or MHR agency enrolls with Magellan you should see no change in your access to services. You can continue to receive services from your current provider if that is what you chose.
As of now, you can continue to access services in the way that you currently access services. Magellan will send out information before their March 1, 2011 implementation date with a member services phone number, as well as other member-related information. After March 1, you will be able go to the provider of your choice and they will contact Magellan to have the services authorized. [The provider will need to be an enrolled provider with Magellan].
There should be no change in how you currently access emergency psychiatric services. Access to emergency psychiatric services can be obtained by going to the nearest behavioral health clinic / provider or an emergency department.
Once a call or request for services is received by Magellan, all youth will be screened by Magellan Member Services staff to determine the type and intensity of services. The initial screen is brief and may be conducted over the phone. If your child is found to be eligible, then a more complete face-to-face assessment will be performed. There is also an assessment for financial eligibility.
Adults will receive a telephone screening to determine eligibility. Some adults, who require more intensive services, may require an independent assessment by a Licensed Mental Health Professional (LMHP). Other adults can be assessed by the provider at the site where they are receiving services.
Magellan has the responsibility of making the determination for what services are clinically appropriate and what services are needed for the recovery of the individual.
Persons should receive notification of eligibility into LBHP through the mail once they are enrolled as a member with Magellan. Basic information including a member services manual should be made available to persons upon enrollment.
You will be provided with written information regarding Magellan’s grievance and appeal process that will explain your rights. A 1-800 number will be established for use in communicating concerns of this type. The grievance and appeal process information will be detailed in the member services manual. Magellan care managers will also be available to assist you with this process.