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Effective 6/1/2024 Magellan Healthcare Will Manage Utilization Management for Applied Behavior Analysis (ABA) Services

Date: 03/26/24

Effective June 1, 2024, Magellan Healthcare will manage the utilization management for ABA benefits for Louisiana Healthcare Connections members. Below are some frequently asked questions we have answered to help better understand this change.

How do I verify eligibility for Louisiana Healthcare Connections members?

  • There are no changes to eligibility verification.
  1. Log on to Louisiana Healthcare Connections Secure Provider Portal at LouisianaHealthConnect.com. Using our secure provider website, you can check patient eligibility. You can search by date of service and either of the following: patient name and date of birth, or patient Medicaid ID and date of birth.
  2. Call Louisiana Healthcare Connections automated member eligibility IVR system at 1-866-595-8133 and follow the appropriate menu options to reach our automated member eligibility verification system 24 hours a day. The automated system will prompt you to enter the patient Medicaid ID and the month of service to check eligibility.
  3. Call Louisiana Healthcare Connections Provider Services. If you cannot confirm a patient’s eligibility using the methods above, call our toll-free number at 1-866-595-8133. Follow the menu prompts to speak to a Provider Services Representative to verify eligibility before rendering services. Provider Services will need the patient’s name or patient's Medicaid ID to verify eligibility.

How do I request authorization for ABA services?

  • All ABA services require preauthorization.

To request initial services, complete the ABA initial authorization form and submit it along with the member’s diagnostic report via fax to Magellan Healthcare at 888-656-5703.

For all subsequent requests, submit your updated treatment plan or the Magellan ABA treatment plan/concurrent review form for continued care via fax to Magellan Healthcare at 888-656-5703.

Find additional information on Medical Necessity Criteria for ABA services, autism spectrum disorders, including forms for requesting ABA initial authorization and concurrent review at https://www.MagellanProvider.com/LHC

Where do I submit claims for Louisiana Healthcare Connections members?

Claims for ABA covered services rendered to Louisiana Healthcare Connections members must be submitted to Louisiana Healthcare Connections. The claims submission timeframe is 365 calendar days from the date services were rendered.

Louisiana Healthcare Connections’ Payer ID is 68069

Louisiana Healthcare Connections
Attention: Claims
P.O. BOX 4040
Farmington, MO 63640-3826

Training for providers is available.

This training is available on-demand Louisiana Healthcare Connections (magellanprovider.com).