Magellan may conduct site visits with providers to assess the quality of care and services provided, evaluate adherence to policies and procedures, and support various quality improvement activities.
They may be conducted as a part of credentialing for participation in Magellan’s network, and on other occasions as determined by quality or clinical reviews.
Site visits can include a review of:
- Appointment availability and procedures for access
- Availability of emergency and after-hours care
- Procedures to maintain confidentiality of member information
- Physical site environment
- Treatment record-keeping practices
- Documentation in member records
- Documentation of contact with PCP
- Credentials verification of licensed clinical staff, and clinical verification and other human resources procedures for direct care staff
- Quality improvement and safety management programs.
Find our policies related to site visits in the Magellan National Provider Handbook (PDF), section 4.