PA Magellan Behavioral Health Initial Referral for Family-Based Services 2018 free printable template

Magellan Behavioral Health of Pennsylvania, Inc. Initial Referral for FamilyBased Services (FBS) Bucks CountyCambria CountyDelaware CountyLehigh CountyMontgomery CountyNorthampton CountyCurrent evaluation

How to fill out PA Magellan Behavioral Health Initial Referral

How to fill out PA Magellan Behavioral Health Initial Referral for Family-Based

1. Gather all necessary personal information about the family member requiring services, including their full name, date of birth, and contact information.
2. Fill out the demographic section for the family, including the names and relationships of family members involved.
3. Provide a detailed description of the child's behavioral health concerns, including observable symptoms and their duration.
4. Include any previous interventions or treatments that have been attempted for the child.
5. Complete the family history section, noting any relevant medical or psychological history.
6. Fill out the insurance information, ensuring to include the policy number and group number.
7. Sign and date the form to confirm the information provided is accurate and true.

Who needs PA Magellan Behavioral Health Initial Referral for Family-Based?

1. Families with children experiencing behavioral health issues that require assessment and intervention.
2. Parents or guardians seeking support for their child's emotional or psychological challenges.
3. Individuals involved in the care or treatment planning for children facing mental health difficulties.

People Also Ask about

What is the Magellan companion guide?

The Magellan Companion Guides provide detailed instructions on exchanging HIPAA compliant ASC X12N transactions with Magellan. The documents are designed for the technical departments or areas responsible for submitting electronic transactions to Magellan.

What is the phone number for Magellan of Virginia?

For quality of care concerns, general questions or comments please call: Toll-free: 1-800-424-4046.

What is the difference between paper and electronic claims?

To send out paper claims, billers will have to enter claim details in the forms provided by insurance companies and send the completed details across. In contrast electronic claims are created and sent to clearinghouses/insurers via their EHRs.

What is Magellan electronic payer ID?

When using the services of a contracted clearinghouse, it is critical that the proper Payer ID is used so the electronic data interchange (EDI) claims are sent to Magellan. The following Payer IDs are required for all clearinghouses: 837P Professional: 01260. 837I Institutional: 01260.

What is Magellan Health legal name?

Magellan Health Inc. (formerly Magellan Health Services Inc.), is an American for-profit managed health care company and subsidiary of Centene that's focused on special populations, complete pharmacy benefits and other specialty areas of healthcare.

What is the payer ID for devoted health?

Magellan's Payor ID number is 01260. Devoted Health will continue to manage the AHCA Medicaid covered services (targeted case management and community behavioral health services) for their members in Medicare dual-eligible special needs plans (D-SNP).

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What is PA Magellan Behavioral Health Initial Referral for Family-Based?

PA Magellan Behavioral Health Initial Referral for Family-Based is a process through which families seek behavioral health services for their members, specifically aimed at coordinating care for children and adolescents with mental health needs.

Who is required to file PA Magellan Behavioral Health Initial Referral for Family-Based?

Typically, the referral must be filed by a qualified healthcare provider, caregiver, or family member who identifies the need for behavioral health services for the child or adolescent in question.

How to fill out PA Magellan Behavioral Health Initial Referral for Family-Based?

To fill out the referral, you should complete the designated form by providing relevant details about the patient, presenting issues, and any necessary background information according to the guidelines provided by PA Magellan.

What is the purpose of PA Magellan Behavioral Health Initial Referral for Family-Based?

The purpose of the Initial Referral is to initiate the process of connecting families with appropriate behavioral health services and support needed for managing mental health conditions.

What information must be reported on PA Magellan Behavioral Health Initial Referral for Family-Based?

The referral must include information such as patient demographics, clinical history, reasons for referral, and any pertinent details about the family and environmental factors influencing the child's mental health.