California
Post-Stabilization Care - Non-Participating Facilities
Magellan Healthcare, Inc.* manages the behavioral health benefits for full-service health plan members.
If a member whose behavioral health benefit is managed by Magellan receives emergency services at your facility and requires post-stabilization care for a behavioral health diagnosis, and you are not a Magellan participating provider, contact us at the following dedicated toll-free numbers to review the member’s ongoing care needs.
- Blue Shield of California MHSA: 1-877-263-9952
- Sharp Health Plan: 1-866-512-6190
Quick Reference Guide
California Provider Quick Reference Guide (PDF)
Handbook Supplement
Handbook Supplement for California (PDF)
Appendices
- California Member Grievance Form -- English (PDF)
- California Member Grievance Form -- Spanish (PDF)
- Independent Medical Review Policy (PDF)
- Claims Settlement Practices and Dispute Resolution (PDF)
- Language Assistance Services (PDF)
- Sample Patient Financial Responsibility Acknowledgement Form (PDF)
Medical Necessity Criteria
Medical Necessity Criteria - see State/Client-Specific Criteria for California
For key points relating to SB 855, see Handbook Supplement for California (PDF), section 3.
Access Standards
To support the established appointment and telephone access standard set forth in 28 CCR Section 1300.67.2.2., we strongly encourage you to follow these standards:
| Urgent Access | 48 hours |
| Non-Urgent Access (Non-Physician) | 10 Business Days |
| Non-Urgent Access (Psychiatrist) | 15 Business Days |
| Follow-up Appointment (Non-Physician) | 10 Days Following Initial Visit, Assessment or Evaluation |
| Follow-up Appointment (Psychiatrist) | 90 Days Following Initial Visit, Assessment or Evaluation |
For additional information regarding appointment and telephone access standards, refer to the California provider handbook supplement, section 3 (PDF).
Magellan asks providers to respond to the annual Provider Appointment Availability Survey (PAAS) which is administered by Sutherland on behalf of Magellan. The PAAS survey is mandated by the California Department of Managed Health Care (DMHC).
California Provider Orientation
Provider Orientation Training (PDF)
Provider Specialty Information
California providers can update their specialty information via our online Provider Data Change Form. Sign in to this website, then click Display/Edit Practice Information.
Applied Behavior Analysis
- For ABA Initial Authorization and Treatment Request / Concurrent Review forms and contact information, sign in to this website. From the Resources section, select State & Plan Information, then choose Autism.
- For California-specific ABA resources, sign in to this website. From the Resources section, select State & Plan Information, then choose California.
Electroconvulsive Therapy, Transcranial Magnetic Stimulation, and Neuropsychological/Psychological Testing Forms
- ECT Authorization Request Form (PDF)
- TMS Authorization Request Form - initial and concurrent (PDF - print for handwritten completion)
- TMS Authorization Request Form - initial and concurrent (Word - download for digital completion)
- Neuropsych/Psych Testing Authorization Request Form (PDF - print for handwritten completion)
- Neuropsych/Psych Testing Authorization Request Form (Word - download for digital completion)
California Medi-Cal Enrollment
- Medicaid/Medi-Cal providers: Enroll with California Medicaid today (PDF)
- Med-Cal Managed Care Provider Enrollment Frequently Asked Questions (PDF)
Billing Tips
- California Telehealth Billing (PDF)
- California License-level Modifiers for Associates/Interns Billing (PDF)
*In California, Magellan does business as Human Affairs International of California and/or Magellan Health Services of California, Inc. – Employer Services.