For Providers

Providing Care

Whether you are initiating care or providing ongoing treatment, obtaining authorizations and utilizing appropriate clinical protocols are essential to the delivery of quality care.

Online tools for providers

By signing in to the Magellan provider website with your secure username and password, you can view authorizations, check member eligibility and much more. You also can update your practice data so that Magellan can provide the most accurate information when making member referrals.

Important Changes to AHCCCS--MVD Photos Added To AHCCCS Online Eligibility Verification

Effective Thursday, Dec. 15, 2011, AHCCCS will be adding photos to its online verification tool that providers use to verify member eligibility. This new feature is one of many efforts by AHCCCS to help protect members and prevent fraud. AHCCCS will obtain photos from the Arizona Department of Transportation Motor Vehicle Division (MVD) of all AHCCCS members who have an Arizona driver's license or a State issued Identification (ID) Card. When providers use the online member verification system and enter a member's social security number, the member's photo, if available from MVD, will be displayed on the AHCCCS eligibility verification screen along with other AHCCCS coverage information. The added photo image will assist AHCCCS providers to quickly validate the identity of a member.

Member Notice: AHCCCS members will be notified of this change through the member portals on the AHCCCS internet website. AHCCCS and its Contractors will also notify members via newsletters and the handbooks. In the future, members will be informed about the addition of MVD photos on their AHCCCS ID card carriers as well as in the Welcome Back letters.

Provider Information/Requirements: Providers are reminded of their continuing obligation to comply with all requirements of the AHCCCS Provider Participation Agreement as a condition of participating in the AHCCCS Program. Paragraph 25 of the Agreement states: "If Provider or any employee or contractor of Provider discovers, or is made aware, that an incident of potential fraud or abuse has occurred, the Provider shall report the incident to the AHCCCS Office of Inspector General (AHCCCS OIG) in accordance with state statutes and AHCCCS policy."

In addition, Arizona Laws ARS §§ 36-2905.04 and 2918.01 require providers to cooperate with AHCCCS to prevent and discover eligibility fraud and to immediately notify AHCCCS of any cases of suspected fraud or abuse.

For the latest information regarding this change, please visit AHCCCS' news and upate portal at http://azahcccs.gov/shared/news.aspx (refer to second bullet on MVD change).

Health-e-Arizona training

AHCCCS provides monthly training to the community on different topics that may be useful to subscribers of their Health-e-Arizona system. The Health-e-Arizona system is an electronic system that allows recipients to apply for AHCCCS benefits online. Click here to view a webinar on "Applying for SMI Applicants Using Health-e-Arizona." Users who have logged into Health-e-Arizona can find the list of upcoming webinars on the Health-e-Arizona site. Select "Links and Contacts" and then "HEALTH-E-ARIZONA 2011 TRAINING."

Medical necessity criteria

• Admission psychiatric acute hospital and sub-acute authorization criteria 
• Continued stay psychiatric acute hospital and sub-acute authorization criteria
• Admission residential treatment center authorization criteria 
• Continued stay residential treatment center authorization criteria 
• Electroconvulsive therapy criteria for authorization 
• Psychological testing criteria for authorization 

Clinical guidelines

• Magellan provider clinical guidelines
• ADHS/DBHS clinical guidance documents

Single points of contact for clinical coordination

• GMHSA provider single point of contact grid (Updated: 09-23-11)

Directory of Women's Treatment Services

• Directory of Women's Treatment Services (Updated 08-08-11)
• Directory of Women's Treatment Services (Spanish) (Updated 09-08-11)

Clinical monographs

The following clinical monographs are available to download.

• Referenced EEG (50K)
• Hippotherapy (34K)
• Prometa protocol (47K)
• Vagus nerve stimulation (52K)
• Vivitrol for opiate addiction (77K)

Prevention resources

• Coalition functioning instrument retrospective survey (50K)
• Coalition functioning instrument retrospective survey (Spanish version) (50K)
• Coalition functioning instrument survey instructions (50K)
• Coalition functioning instrument training Power Point presentation (50K)
• Community assessment training Power Point presentation (50K)
• Community readiness assessment instructions (50K)
• Community readiness assessment interview questions (50K)
• Community readiness assessment (Spanish version) (50K)
• Community readiness assessment training Power Point presentation (50K)
• Risk and protective factors training Power Point presentation (50K)
• Substance abuse data resources (50K)
• ADHS core instrument for adolescents (50K)
• ADHS core instrument for adolescents (Spanish version) (50K)
• ADHS core instrument for older adults (50K)
• ADHS core instrument for older adults (Spanish version) (50K)
• Parent-child bonding instrument (50K)

Access to interpretation services

• Magellan language service vendor directory (77KB, Oct. 2011)
• Interpretation service flow chart (18K)
• Web site access to qualified interpreters (39K)
• Interpreter request form (11K)

Error resolution guide

• Error resolution guide (141K Updated: 07-11-11)

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