region/plan-specific news
: Employer Plans Nationwide
Treatment record reviews demonstrate quality of care
We are committed to quality care and rely on you, our valued network provider, to embody this in your practice. To this end, Magellan conducts treatment record reviews on an annual basis.
In 2023, the Magellan care management center serving employer plans reviewed 172 separate providers and cases. The results indicated that providers demonstrated the attainment of high quality standards in treatment record documentation. The aggregate score for all the cases reviewed was 83.1%, which far exceeded the goal of 70%.
Six documentation categories on target
- General demographic information – 84.7%
- Initial clinical evaluation (full clinical assessment of client’s presentation) – 90.9%
- Individualized treatment plan (for practitioners providing therapy services only) – 74.6%
- Ongoing clinical treatment and progress – 90.9%
- Coordination of care supplemental – in cases where coordination occurred – 94.8%
- Medication management – 80.4%
Two areas for improvement
However, two categories stood out as areas for improvement:
- Consumer rights and confidentiality explained and documented (includes consent for treatment and medication) – 50.0%
- Coordination of care (with member’s primary care and other treatment providers) – 27.8%
We strongly encourage you to incorporate these areas into your medical record processes to demonstrate your efforts and attention to ensuring quality, whole-person member care and education.
Resources to support you
- Treatment record documentation templates on the Clinical Forms page of our provider website will assist you in meeting Magellan’s documentation standards for specific employer plans. Of note, we provide documentation form templates for treatment consent, medication consent, and coordination of care as well as other clinical forms.
- The treatment record review tool is also available on the Clinical Forms page. Magellan reviewers use this tool when evaluating treatment records. This will apprise you of the areas and elements we review.
- Section 4: The Quality Partnership section in Magellan’s provider handbook includes information about treatment record and clinical practice guidelines review standards.
Have questions about record reviews?
Contact Lorraine Langdon-Hull at (314) 387-4892 or LGLangdon-Hull@MagellanHealth.com.