BCBS AND MAGELLAN
We have acquired more detailed information regarding the recent letter from BCBS and the change that will take place with Magellan January, 1, 2010.
The change is not going to effect all BCBS PPO policies. Patients whose policies currently carve out to Magellan for inpatient psychiatric visits will also carve out to Magellan for outpatient mental health visits when this change takes place. BCBS PPO policies that do not require an authorization from Magellan for inpatient will stay the same in 2010 and will not carve out to Magellan.
According to the information that we received the reimbursement rate will remain at the BCBS level.
At this time there is no requirement to be paneled with Magellan to receive reimbursement on these policies, but with all of the changes that are taking place we suggest that you become in-network with Magellan if you are currently out of network so that no additional issues in reimbursement will arise.
For those of you that are current clients of Medicus we will be adding inpatient benefit levels to the verifications that are sent to you. This is going to let us know which policies require a Magellan authorization for inpatient so that we are fully prepared to get outpatient authorization for the policies in which it is required at the first of the year.
This is all preliminary information and may or may not change from now until January, but we will update you on any new developments as they are received.
Please feel free to forward this to any provider that is concerned about the change. We are available to take any calls from providers that have questions regardless if they are current clients. We hope this gave a bit more clarity to the change taking place. Have a wonderful day.
Sincerely,
Stephanie M. Knispel
President
sknispel@medicusout
MEDICUS Consulting & Outsourcing, Inc.
15436 Lamon Ave
Oak Forest, IL 60452
Phone:(708) 535-7347
Fax: (708) 535-7396
Cell: (708) 704-0172
http://medicusoutso
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