EAP Chart Review Results Remain High
Every year Magellan’s California Care Management Center* reviews a random sample of provider records on Employee Assistance Program (EAP) services to our members. This review is a component of our Quality Improvement Program that helps us to validate, through provider record documentation, the quality of care provided and to identify documented areas that can be improved. We are pleased to report that in 2007, the average score per chart was an excellent 93 percent, representing only a slight decrease from the 95 percent achieved in 2006.
Just a few providers scored below the 85 percent benchmark. As in the past, we found that those providers were not using the Magellan EAP clinical forms. We highly recommend using these forms as they are designed to capture all critical information, as well as to comply with requirements imposed by regulatory agencies, such as the California Department of Managed Health Care. As always, we sent each provider their individual results, congratulating them and noting areas for improved documentation.
View Detailed Results (PDF)
Results
As seen in the document/link above, California EAP providers continue to develop appropriate EAP treatment plans, and to document member progress and treatment outcomes. Two areas showed a strong improvement:
- Telephonic follow-up – from 69 percent in 2006 to 88 percent in 2007
- Thorough assessment in support of the diagnosis of depression or substance abuse – from 60 percent in 2006 to 77 percent in 2007.
Despite these overall excellent results, we noted one important area of focus for future improvement:
Signed Statement of Understanding (SOU)
Each member of adult age receiving EAP services must sign a SOU indicating that he/she understands the nature of EAP services. For minors, a parent or legal guardian must sign the SOU. The SOU protects you and Magellan against complaints or litigation that can arise out of possible misunderstandings regarding the scope of EAP services and attendant confidentiality. Please note, the referral package that we send for a particular case only includes an SOU if the client organization has a company-specific SOU form. EAP providers who do not receive an SOU with the referral package, or who have not received a referral package at the intake session, should have the member sign a generic SOU. You can find EAP clinical forms, including the generic SOU, on this website. It is not necessary to wait for a referral package.
We thank you for your cooperation in the chart audit process, and appreciate your continued commitment to providing the best services to our EAP members.
*Two Magellan subsidiaries, Magellan Health Services of California, Inc. -- Employer Services and Human Affairs International of California, Inc., operate out of the California Care Management Center.