Network Notes
Our Partners in PHI Protection
As member advocates, Magellan continuously strives to prevent unauthorized disclosures of our members’ Protected Health Information (PHI), and is committed to appropriately safeguarding all member PHI. But, you can help too! We would like to share some situations where by working together with you—our providers—we can help minimize the potential for unauthorized disclosures of member PHI.
As Magellan providers, you can help us avoid unauthorized disclosures of member PHI by taking the following actions:
- Call in for benefit authorizations yourself (or obtain initial authorizations securely via MagellanHealth.com/provider) rather than instructing the member to do so. Frequently, members do not have all the necessary provider information required for an accurate authorization, and Magellan staff may select the wrong provider for an authorization based on faulty information furnished by the member.
- Call the specific toll-free number on the member’s card. Magellan is made up of multiple departments and teams at various sites throughout the country, each with their own dedicated phone number. Calling the appropriate number will ensure you reach the correct team responsible for managing the member’s behavioral health benefits.
- Contact Magellan immediately if you receive any communication regarding a member who is not in your care so that we may correct our records, avoid possible reoccurrences of the disclosure, and comply with reporting requirements regarding unauthorized disclosures.
- Contact Magellan immediately with changes in your contact information by updating your practice information via secure login at MagellanHealth.com/provider (address, telephone number, fax number, etc.) so you can continue to receive important information from Magellan.
- Obtain a copy of the member’s insurance ID card and verify that it is still current at every appointment.
- Verify member identity with a driver’s license (or other valid picture ID) to prevent medical identity theft.
- Use online eligibility applications only after a member’s identity has been confirmed. Make sure that you have found the correct person in a Magellan system by verifying as much information as possible, including the member’s name, member number/ID, date of birth, address, and the subscriber on the insurance plan. Due to the sheer volume of members we serve, there is likely to be more than one person in our system with your patient’s name.
- Contact Magellan if you are not able to confirm additional information with the member or the member does not have an ID card. Be sure to tell the Magellan staff member that you are calling about a member who does not have an ID card with them.
- Obtain written authorization from the member when communicating with other providers involved in a member’s care. (See Magellan’s provider handbook, Section 3, “Continuity, Coordination and Collaboration” for more information.)
You can find additional information regarding “Uses and Disclosures for Treatment, Payment, and Health Care Operations” on the U.S. Department of Health & Human Services’ website.
Thank you for your attention to the critical task of protecting member information and avoiding unauthorized disclosures.