We have expanded our contract with Magellan Behavioral Health Services (BHS) to include coordination of outpatient mental health/chemical dependency services for members who currently have Magellan for their behavioral health benefits.

What does this expansion mean?
Effective January 1, 2010, the following process change will occur for members needing behavioral health services:

• You must pre-authorize both inpatient and outpatient behavioral health services (office visits are included).
• To obtain pre-authorization, you must contact Magellan BHS. The contact information is located on the back of the member’s ID card. Magellan BHS will also verify eligibility and benefits for the member.

Note: Failure to pre-authorize behavioral health services may result in nonpayment of claims. Members will be held harmless if their in-network provider fails to pre-authorize services.

Which members are affected by these changes?
The contract expansion applies to all BCBSIL PPO members. Members in HMO Illinois and Blue Advantage HMO are not included in this program.

How often is pre-authorization required?
Contact Magellan BHS prior to the initial visit. They will typically approve the initial assessment visit along with five additional sessions to establish a clinical treatment plan. To obtain approval for additional visits, you will need to complete a treatment request form, which will be supplied by Magellan BHS.

For more information:

• Contact Magellan BHS directly at (800) 851-7498 if you have any questions concerning the pre-authorization process.
• Your Provider Network Consultant (PNC) is also available to discuss these changes with you. To locate the name of your assigned PNC, please access the Professional Provider Network Consultant List.
• Watch our Web site to register for upcoming informational Webinars we will be hosting for professional provider and facility office staff.

More detailed information on behavioral health benefit changes, including pre-authorization guidelines, and transition of care processes, will be forthcoming on this site and in our monthly Blue Review provider newsletter.