Magellan Health

For Providers

Audits

This page provides information about the NOA audit process, the NOA audit tool, and the NOA audit schedule. 

Audit Process

To reach NOA compliance, several audits occur on a monthly basis. Below is a chart to help you identify what the submitting requirements are for different types of providers. 

For Children's PNOsFor Adult PNOs

Children's PNOs are required to:

  • Keep a monthly log of NOAs issued.
  • Submit a copy of their NOA log by the seventh (7th) of the month.
  • Audit the PNO NOAs and a sample of the NOAs issued by the PNO's sub-providers.
  • Submit the audit results and the NOAs audited by the 15th of the month

The NOA documentation should be in the following order, in one continuous scan or fax:

  • Notice of Action
  • Legal Services Attachment
  • 5.3.1 Form
  • Supporting Documentation for the decision

 

Adult PNOs are required to:

  • Keep a monthly log of NOAs issued.
  • Submit a copy of their NOA log by the seventh (7th) of the month along with two NOA's per clinic to be audit.

The NOA Documentation should be in the following order, in one continuous scan or fax:

  • Notice of Action
  • Legal Services Attachment
  • 5.3.1 Form
  • Supporting documentation for the decision.

Any providers not under the umbrella of a PNO will be randomly audited throughout the year. In addition, any appeals filed involving a provider or RBHA NOA will also be audited.

NOA Audit Tool

NOA Scores

Coming Soon! The scores will be reported in the provider profile.

If you are struggling to reach compliance, or feel that you need some NOA assistance, please contact us with the following information:

  1. Your name and contact information,
  2. Your NOA question,
  3. The type of services you provide and/or the most common NOA issues, and
  4. The number of people currently working on creating NOAs. 

Back to NOA homepage.

 

 

 

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Contact Information

Mercy Maricopa Integrated Care (Mercy Maricopa) is now the Regional Behavioral Health Authority (RBHA) serving members in the Maricopa County Region. For questions regarding your services, please call 1-800-564-5465 or TDD/TTY 711.

** To file a grievance or appeal for services provided on or before March 31, 2014 please call Magellan Health Services 602-652-5907, x8590