Magellan Healthcare, Inc. (Magellan) is a managed care behavioral health care company contracted by AmeriHealth to manage the mental health and substance abuse benefits for the majority of our Members with HMO, POS, PPO, EPO, and CMM coverage. Magellan develops and contracts with its own network of behavioral health providers.

Members are not capitated to a specific behavioral health site. However, for a Member to receive the highest level of benefits, behavioral health services must be provided by Magellan behavioral health providers.

Note: Magellan is available 24 hours a day, 7 days a week, at 1-800-809-9954.

Precertification delegated to Magellan

Precertification review has been delegated to Magellan for:

• Autism spectrum disorders
  • – Applied behavioral analysis
• inpatient substance and alcohol abuse services
• mental health inpatient services
• partial hospitalization programs
• intensive outpatient programs,
• repetitive transcranial magnetic stimulation (rTMS)

Note: Members must call Magellan once an appointment has been made to ensure that the precertification process is properly initiated.

For more information

Please refer to the Clinical Services – Utilization Management or the Behavioral Health sections of the Provider Manual for Participating Profession Providers for more information on Magellan.

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