Magellan National Provider Handbook Appendices
Appendix A: Audit Tools
- Treatment Record Documentation Worksheet
(PDF
146K) - Depression/Suicide Clinical Practice Guideline Audit Tool (PDF 53K)
- Schizophrenia/Suicide
Clinical Practice Guideline Audit Checklist (PDF
40K)
- Substance
Use Disorder/Suicide Clinical Practice Guideline Audit Tool (PDF
39K)
Appendix B: Professional Provider Selection Criteria
- Individual
Providers (PDF
26K)
Appendix C: Medical Necessity Criteria
Appendix D: Member Rights and Responsibilities
- English (PDF
101K)
- Spanish (PDF
33K)
- Condition
Care Management Member Rights and Responsibilities (PDF
40K)
- Condition
Care Management Provider Rights (PDF
84K)
Appendix E: Magellan Clinical Practice Guidelines
Appendix F: Claims
- Coordination
of Benefits (PDF
68K)
- Elements
of a Clean Claim (PDF
51K)]
- Claim "Dos" (PDF 28K)
- Claim "Don'ts" (PDF 28K)
- How
to Read Your EOP Statement (PDF
79K)
- Approved Clearinghouse Contact Information (PDF
14K)
Appendix G: Frequently Asked Questions
- Individual
Contracting and Credentialing (PDF
36K)
- Group
Provider Credentialing and Contracting (39K
PDF)
- What
is Re-Credentialing? (PDF
35K)
Appendix H: Clinical Monographs
- Psychiatric
Consultation (PDF
63K)
- Split
Therapy (PDF
109K)
- Medical
Detoxification (PDF
234K)
Appendix I: Prevention
Program Descriptions (PDF
78K)
Appendix J: Fraud and Abuse Compliance Policies
- Medicaid:
Fraud and Abuse Program Policy (PDF
155K)
- Medicare:
Fraud and Abuse Program Policy (PDF
155K)
-
False Claims Laws and Whistleblower Protections Policy (PDF
33K)
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