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Behavioral Health Managed Care Providers Resources
Managed Care Provider

Easier Access Through the Internet
Whether a network provider, or an out-of-network provider for a a managed care company, we all know how difficult it can be to contact them and receive quick service. Being on hold for twenty minutes  or more, getting numerous voice mailboxes, or being diconnected is not unusual. However, I have found that Internet-mediated communications with a MCO can be much more effective.  

Many of the managed care companies now have provider websites. Some MCOs can authorize treatment requests online, and most have the various provider forms you need online.

Another wonderful benefit of e-mail communication is that you have written documentation of your contact and communications automatically (if you save your e-mails).  How many times have you called a MCO, discussed an issue with a provider relations person (who usually remains nameless), only to call back later to continue the discussion and either you can't find the same person you were talking to, or there is no record of your previous call?

All of the MCO sites are not listed here.  If you come upon a MCO site that is not listed, please e-mail me at EGeratyLSW@aol.com  and let me know.  I will add it.
CareFirst BlueCross BlueShield

The CareFirst For Providers site contains administrative guidelines, contact numbers, medical policies, and clinical resources
Cigna

Cigna's Tools and Support for Behavioral Health  website gives you telephone and contact addresses, and policies and procedures guidelines
Community Behavioral HealthCare Network of Pennsylvania

There does not seem to be a specific website for providers but there is a list of e-mail contacts
Aetna  

The Medical Services and Tools website is geared primarily toward physicians.  I could not find a specific section for behavioral health providers. However, you will find coverage policy bulletins, a provider application form, and other information.
APS Healthcare

The APS Information for Providers site contains provider forms, the provider manual, and contact information
Federal Employees Health Benefits Program

The Federal Employees site is a consumer site, but does link to the Tricare and Medicaid sites.
Kaiser Permanente

The Kaiser webpage doesn't really have a provider site ( or at least I couldn't find it). There is a "Our Locations" page.
Magellan

Magellan Provider.com contains an online treatment authorization process, EAP forms, a printable version of the provider handbook, treatment plan forms, and contact information.
Oxford Health Plans

You will need a user name and password to access their Provider page.
United Behavioral Health

The UBH site has a claims inquiry, authorization inquiry, and web claim entry process, as well as forms, guidelines and policies. You must have a log in pass.
ValueOptions  

The Providers site has information on electronic claims submissions, HIPPA regulations, the provider handbook, and contact information
A note about e-mailing the MCO. Sometimes it is not easy to find and e-mail contact for provider services on the MCO websites.  Some make it easy, some make it difficult.  If the MCO does not have a specific Provider Services e-mail contact, keep looking.  There will usually be SOME e-mail address associated with the MCO SOMEWHERE  on the site. I have even contacted the Investor Relations e-mail addresses, stated my issue, and asked for a response with a Provider Services e-mail included.  Sometimes it WORKS !
Other Resources
The Consumer’s Right To Health Care:
This site was developed by Ed Geraty LCSW-C, a private practitioner in Baltimore, MD. Feel free to contact him at EGeratyLSW@aol.com

 

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