CCCPlus Members Excluded from the Eligibility File

October 30, 2017

We rarely repost messages from Magellan, but this one deserves close attention:

“This provider communication serves as an acknowledgement of an error that occurred to the eligibility file that DMAS sends to Magellan of Virginia. The eligibility file erroneously left out members transitioning to the CCC Plus benefit. Thus effected members are not showing as active in Magellan of Virginia’s system which may impact eligibility verification and services authorizations being submitted in Magellan of Virginia’s system.

“If you are a provider who has a member in the CCC Plus benefit and in need of mental health services covered through Magellan of Virginia, providers may contact Magellan Customer Service at 1-800-424-4046 for CCC Plus members impacted to have coverage updated manually and then proceed with service authorization requests (SRA) via the provider portal.

“DMAS and Magellan are actively working on a resolution. Until further notice, providers may submit a retrospective request for any CCC+ members that were impacted. Providers should indicate that this is a “retro” on the service authorization request by checking off the box on the SRA. In the first text box the provider should state “This is a retro request due to a previous error in eligibility.“ This will allow providers to enter in past dates of service.”