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Improved access to tele-behavioral health services for AmeriHealth members

June 11, 2019

In addition to our existing telemedicine services, Magellan Healthcare, Inc. (Magellan) began offering tele-behavioral health services to AmeriHealth members on January 1, 2019.* This benefit is available to all members enrolled in an AmeriHealth health plan that offers behavioral health services through Magellan.

Important information for AmeriHealth New Jersey providers

The Magellan tele-behavioral health services are in addition to the existing AmeriHealth New Jersey policy based on the State of New Jersey telemedicine law (P.L. 2017, c117) requiring insurance carriers to cover telemedicine services, which went into effect July 21, 2017.

Please read our previously published article for information on the existing policy and collecting member copayments.

According to the National Alliance on Mental Illness, emotional health disorders affect over 25 percent of people, many of whom do not have access to mental health services, and costs employers over $193 billion a year.1 Many of these conditions are associated with:

  • high levels of distress
  • disability
  • morbidity
  • mortality

Tele-behavioral health services increase the opportunity for members to access needed help and resources.

Benefits of tele-behavioral health services

Members can more easily access tele-behavioral health services for the same cost as an office visit. Two key benefits include:

  • Privacy: Members have access to confidential video teleconference services with a counselor in a private setting.
  • Convenience: This allows members who cannot travel, or have limited time to travel, to set up more convenient appointment times.

These added benefits help reduce the stigma associated with misconceptions about behavioral health and mental illness which often is a barrier to members receiving mental health services.1 Along with On To Better Health, these confidential online programs increase access to more tools and resources to help members with their emotional health and wellness.

Accessing tele-behavioral health services

Later this year, members will be able to locate licensed tele-behavioral health providers using the Find a Doctor tools for AmeriHealth New Jersey and AmeriHealth Pennsylvania. Tele-behavioral health providers will have an indicator to identify themselves as tele-behavioral health providers.

Providing tele-behavioral health services

Coverage for tele-behavioral health services may vary among plans. It is important for providers to verify coverage prior to rendering tele-behavioral health services. Members must have outpatient mental health benefits. Providers can check the members behavioral health coverage with the Eligibility and Benefits Inquiry transaction on the NaviNet® web portal (NaviNet Open) by selecting Additional Benefit Provisions and then choosing Behavioral Health/Substance Abuse.

For instructions on how to use this transaction, refer to the Eligibility and Benefits Inquiry Guide, which can be found under User guides and webinars in the NaviNet Resources section.

More information

For more information, visit the telehealth toolkit on the Magellan website, or contact Magellan Provider Services at 1-800-788-4005. 

*Tele-behavioral health services are defined by Magellan as delivering behavioral health services using interactive telecommunications when the member and the behavioral health provider are not in the same physical location. Telecommunications must be the combination of audio and live, interactive video. More information can be found here.

1www.nami.org/Learn-More/Mental-Health-By-the-Numbers

Magellan Healthcare, Inc. manages mental health and substance abuse benefits for most AmeriHealth members.

NaviNet® is a registered trademark of NantHealth.


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