Behavioral health vendor brings new directions to member care management, provider satisfaction

As announced in last month’s edition of The Record, New Directions LLC will begin managing Blue Cross Blue Shield of Michigan’s behavioral health services on April 1, 2015. New Directions will replace Magellan Behavioral of Michigan Inc.

New Directions will assume behavioral health management of 2.5 million Blue Cross commercial members nationwide. Services include preauthorization and case management for members who receive behavioral health through Blue Cross.

Please note that providers do not need to contract with New Directions to be part of the network: Our existing Traditional and PPO network and fees will continue.

It’s also important to note that the State of Michigan group account and other accounts that have behavioral health currently managed by another vendor arrangement (e.g., autos, UAW retirees, DENSO and others) are not affected by this change. The transition to New Directions does not affect these customer groups or network providers.

About New Directions
New Directions is a managed behavioral health organization accredited by the National Committee for Quality Assurance. It has more than 20 years of experience in utilization and case management services, in addition to extensive experience working with Blue plans nationwide.

With its offices located in Kansas City, Missouri, New Directions currently manages Blue Cross’ employee assistance program.

Blue Cross members and providers are expected to benefit from a number of program and service enhancements that were previously unavailable, including:

• An award-winning service center providing 24/7 toll-free access for members and providers
• Integrated care programs that use an evidence-based approach to services for members across the continuum of care
• Discharge planning and follow-up appointment scheduling (for members admitted to inpatient and residential levels of care) that is closely monitored to ensure supportive transitions to and within the community.
• Case managers that work one-on-one with members to improve care transitions, foster self-management and remove barriers to care
• Use of claims data to build predictive models that identify members at-risk for relapse or readmission, and which subsequently enable targeted outreach efforts to these members

Streamline authorizations with WebPass
New Directions will continue current authorization practices that waive the initial four days of inpatient care when admission notification is submitted, with clinical review required after day four. In addition, providers will be able to take advantage of authorization process enhancements intended to decrease unnecessary phone calls and minimize less secure communications such as e-mails and faxing. Among these improvements is the use of an online authorization application called WebPass.

WebPass is a secure Internet portal that enables providers to document and submit clinical information online to New Directions for higher level of care initial authorizations and continued stay reviews. Providers should note, however, that authorization requests for autism services and repetitive transcranial magnetic stimulation, or rTMS, treatments will continue to be processed by phone.

Following a one-time facility registration process at the WebPass website, facility providers will receive individual user names and passwords used to log in to WebPass. As of March 10, 2015, facilities can register as a user on WebPass.  After logging in to the website, providers can enter a Blue Cross member ID (or name and date of birth information) to perform a variety of tasks related to the member. These tasks include admission requests and reviews, case management and quality reviews. Regardless of the task performed, member information is preloaded into requested documentation.

Learn more online
Blue Cross has scheduled a number of informational events about the transition to New Directions. A WebPass training webinar is scheduled for mid-March.

Please watch for notifications on web-DENIS about the following:

• Availability of New Directions’ medical necessity criteria
• WebPass training webinar date
• Finalizing and sharing the case transition plan from the current behavioral health vendor to New Directions for all levels of care