Magellan Announces Provider Changes

In June, Magellan announced changes to their provider contracting system primarily affecting provisionally-licensed therapists. Here is the text of that letter:

Dear Provider:

As you are aware, Magellan Behavioral Health* (Magellan) manages mental health and substance abuse services for Nebraska Medicaid Managed Care Plan (NMMCP) members. In collaboration with the Division of Medicaid and Long-Term Care, Magellan is implementing changes in policies regarding the inclusion of provisionally licensed clinicians for the NMMCP provider network. These changes are applicable to provisionally licensed psychologists, provisionally licensed mental health practitioners (PLMHPs), and provisionally licensed alcohol and drug abuse counselors (PLADCs).

Effective July 1, 2008, we will implement the following guidelines regarding the inclusion of provisionally licensed clinicians for the NMCCP provider network:

• Provisionally licensed clinicians who are currently NMMCP network practitioners in private or group practices will be "grandfathered in" and will remain in active status in the NMMCP network for up to two years, or July 1, 2010. As of July 1, 2010, practitioners must be fully licensed to continue network participation in private or group practices.

• Provisionally licensed clinicians who are employed by an NMMCP-contracted organization will continue to be accepted for network participation. However, provisionally licensed clinicians who terminate their employment from an NMMCP-contracted organization will not be eligible for network participation in group or private practices until such time they become fully licensed.

• Provisionally licensed clinicians who are not currently credentialed and contracted for the NMMCP provider network will not be accepted for network participation in private or group practices.

• In order to remain in active network status, existing NMMCP network practitioners in private or group practices who have a provisional license due to expire prior to July 1, 2010, must become fully licensed prior to the expiration of their initial provisional license. Practitioners will not be allowed to continue network participation on a renewed provisional license.
  

Thank you for your cooperation with this matter. If you have any questions, please contact Teresa Danforth at (402) 437-4241 or Kathy Dinges at (402) 437-4214.

APPT Survey: After-Hours Emergency Policy

Recently, the Association of Private Practice Therapists conducted a survey of its members to determine if there is a local standard for how after-hours emergency calls are handled.

The survey was commissioned by the APPT Board of Directors in response to an insurance/managed care company's request for a therapist's after-hours emergency policy.

The full results of the survey will be reported in the October 2008 issue of The Compass, the newsletter of the Association of Private Practice Therapists. Beyond the results, however, it appears as if therapists may be struggling with their ethical requirement to serve clients with the practical applications of after-hours service -- of particular issue with sole practitioners.

"We have maintained the cost of a 'company' cell phone and a live answering service for many years," one therapist writes. "We have begun to question the need and utility of this, and will likely drop this soon. At the end of the day, if someone has a crisis that is life-threatening, talking to us just delays going to the hospital."

Magellan Health Offers Online Learning Tools

Magellan Health Services Inc. is offering therapists a new online learning center designed to reinforce resiliency and recovery principles. The Magellan Resiliency and Recovery e-Learning Center enables consumers, families, and providers to effectively apply the principles of hope, choice, empowerment, and education to help achieve individual behavioral health goals.

The e-Learning Center offers broad access and greater convenience than traditional on-site learning programs, and without the expense. It's a free resource that currently hosts 10 interactive "e-courses" in Spanish and English, offering in-depth strategies and techniques for promoting resiliency and recovery. The e-courses include testimonials of personal experiences that provide motivation and each can be completed in 30-45 minutes.

Magellan providers are able to receive Continuing Education Units (CEUs) for completing the e-courses. Magellan is approved as a continuing education provider/sponsor by the American Psychological Association, Association of Social Work Boards, National Association of Alcohol and Drug Abuse Counselors, and the National Board of Certified Counselors.

August 15, 2008 Meeting Agenda

Conversation with Medicaid/Magellan for Private Practice Therapists:

What the LIMHP means to you, Documentation and other Requirements, 

Impact of LIMHP on other Insurance Panels, and More

Mahoney State Park

August 15, 2008

8:15-12:15 PM

8:15 – 8:45  Networking and check-in

8:45 – 10:00 Medicaid/Magellan speakers

A.    LIMHP versus LMHP

B.    Definition of “supervision” versus “consultation” in private practice

C.    Documentation and bookkeeping requirements for Medicaid/Magellan

D.    Definitions unique to Medicaid (ie. family therapy)

10:00 – 10:45 question and answers

10:45 -- 11:00 Break

11:00 – 12:00  Erickson & Sederstrom: Legal issues

A.    Medicaid Federal Audits

B.    What does the LIMHP status mean for private practitioners in Nebraska

C.    LIMHP versus LMHP and provider panels

D.    Good Documentation

12:00 – 12:15  Q & A

Don't Need Any New Clients?

Congratulations. You don't need to read this post.

For everyone else, you may already know that as soon as you stop seeing new clients, your practice begins to stagnate and die.

Even if you have clients who are committed for life -- things change. People move. People die. People are "cured" and no longer need your services. Natural attrition is reason enough for you to continually seek out new prospects for your services.

Your success as a private practitioner depends on five things. They are:

• Your ability to assess the needs of your clients.
• The ability to provide services that meet your clients' needs.
• Skill in communicating the benefit of your services.
• Providing follow-up to keep a loyal and satisfied clientele.
• Developing and maintaining a professional network as a referral and support system.

How are you doing in meeting your goals in all five of these areas?

Using Your Mailing List Effectively

Mailing lists are an excellent way to increase your referrals.

1. Build a mailing list of all past and present clients and referral sources. Also consider adding your suppliers (vendors) and members of the media.
   
2. Send a mailing to everyone on your list at least quarterly, whether it's a newsletter, copeis of news clippings or articles, announcements of TV or radio appearances, workshop or group notices, special offers, or just general information about your services.
3. Keep your mailing list up to date -- add the line "Address Correction Requested" below your return mailing address. You'll have to pay for the address correction notice you receive, but it's cheaper than undelivered mail.
4. Include a request for more information in all your mailings. This can be a simple box that asks "Want More Information About Our Services? Call 000-0000" or it can be as elaborate as a postage pre-paid postcard.

Interested in mailing to other mental health practitioners? Call APPT at 402-393-4600 on how to get a list of all licensed mental health practitioners in the state, or just those in our database.

The Cost of Mental Illness

The National Institute of Mental Health just released a study that quantifies the cost of lost productivity due to mental illness at more than $193 billion annually.

A key finding:
Mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity.

The bad news is that suffering from a serious mental problem also affects a person’s ability to work, thus leading to earnings lost for those involved and for the U.S. That was exactly what researchers at the NIMH wanted to underline in their study.