Magellan Wins CareFirst Mental Health Contract

Magellan Wins CareFirst Mental Health Contract

CareFirst has selected Magellan Behavior Health, Inc. to be the only Mental Health and Substance Abuse vendor to service accounts in both Maryland and the National Capital Area. Effective July 1, 2002, Magellan replaced Health Management Systems (HMS) in the National Capital Area. This will not affect Blue Cross Blue Shield of Delaware.

The purpose for the consolidation of mental health vendors is to expedite workflow and to improve administrative efficiency.

For Members Who HAVE Magellan Now:

The transition should not result in any disruption for members who currently have Magellan as their mental health vendor. Processes are the same as before and members will continue to use current ID cards. These members should only notice a change in service protocol:

• CareFirst of Maryland, Inc. (CFMI)
• FreeState Health Plan (FSHP)
• Delmarva Health Plan (DHP)
• Some Maryland-based BlueChoice groups

For Members Who DON'T HAVE Magellan Now:

Members in the National Capital Area could experience a few minor changes during the transition to Magellan. These groups will be affected:

• Group Hospitalization and Medical Services, Inc. (GHMSI)
• D.C.-based BlueChoice business

In an effort to assist accounts and members, letters were sent to all of those affected by the change in May. The following questions and answers were included in the letters to reassure members by providing important information that should address their concerns.

Who is Magellan Behavioral Health?

Magellan Behavioral Health is an administrator of behavioral services and has served our Maryland area health plan members for nearly a decade. Headquartered in Columbia, MD, Magellan is one of the country's leading behavioral health managed care organizations, serving approximately 70 million individuals nationwide.

How will this change impact my group?

The process for obtaining care has not changed. However, if your group was previously served by HMS, beginning at the time of your group's next renewal, members will be required to call Magellan rather than HMS for all mental health and substance abuse services. The phone number will be on the new ID card issued to members. The number is 800-245-7013. To ensure that a specific doctor is in the Magellan network, members should visit CareFirst's Online Provider Directory, refer to their printed provider directory, or call the phone number on their ID card.

Is the Magellan provider network different from the HMS network?

Yes, not all of the HMS providers are part of the Magellan network. However, contracting efforts are taking place to ensure a larger network, thus minimizing disruption of care to members. This means only a few members will potentially be required to select a new mental health provider.

What if a member is currently receiving treatment from a provider not in the Magellan network?

If a member's behavioral care provider is not in the Magellan network, Magellan will work with the member to transition care to a new provider.

Will my employees be notified?

Members will be notified by mail prior to their renewal date.