confidential attachment 10. sample reports...
TRANSCRIPT
Confidential Attachment 10. Sample Reports Tracking
Revenues and Expenditures by Funding Source
Magellan Health Services, Inc. CONFIDENTIAL 1
Magellan Health Services, Inc. CONFIDENTIAL 2
Magellan Health Services, Inc. CONFIDENTIAL 3
Magellan Health Services, Inc. CONFIDENTIAL 4
Magellan Health Services, Inc. CONFIDENTIAL 5
Magellan Health Services, Inc. CONFIDENTIAL 6
Confidential Attachment 11. Sample Reports Monitoring Contractual Performance and
Operations
Magellan Health Services, Inc. CONFIDENTIAL 1
Magellan Health Services, Inc. CONFIDENTIAL 2
Magellan Health Services, Inc. CONFIDENTIAL 1
Magellan Health Services, Inc. CONFIDENTIAL 2
Magellan Health Services, Inc. CONFIDENTIAL 3
Magellan Health Services, Inc. CONFIDENTIAL 4
Magellan Health Services, Inc. CONFIDENTIAL 5
Magellan Health Services, Inc. CONFIDENTIAL 6
Magellan Health Services, Inc. CONFIDENTIAL 7
Magellan Health Services, Inc. CONFIDENTIAL 8
Magellan Health Services, Inc. CONFIDENTIAL 9
Magellan Health Services, Inc. CONFIDENTIAL 10
Magellan Health Services, Inc. CONFIDENTIAL 11
Magellan Health Services, Inc. CONFIDENTIAL 12
Magellan Health Services, Inc. CONFIDENTIAL 13
Magellan Health Services, Inc. CONFIDENTIAL 14
Magellan Health Services, Inc. CONFIDENTIAL 15
Magellan Health Services, Inc. CONFIDENTIAL 16
Magellan Health Services, Inc. CONFIDENTIAL 17
Magellan Health Services, Inc. CONFIDENTIAL 18
Magellan Health Services, Inc. CONFIDENTIAL 19
Magellan Health Services, Inc. CONFIDENTIAL 20
Magellan Health Services, Inc. CONFIDENTIAL 21
Magellan Health Services, Inc. CONFIDENTIAL 22
Magellan Health Services, Inc. CONFIDENTIAL 23
Magellan Health Services, Inc. CONFIDENTIAL 1
Magellan Health Services, Inc. CONFIDENTIAL 2
Magellan Health Services, Inc. CONFIDENTIAL 3
Magellan Health Services, Inc. CONFIDENTIAL 4
Magellan Health Services, Inc. CONFIDENTIAL 5
Magellan Health Services, Inc. CONFIDENTIAL 6
Magellan Health Services, Inc. CONFIDENTIAL 7
Magellan Health Services, Inc. CONFIDENTIAL 8
Magellan Health Services, Inc. CONFIDENTIAL 9
Magellan Health Services, Inc. CONFIDENTIAL 10
Magellan Health Services, Inc. CONFIDENTIAL 11
Magellan Health Services, Inc. CONFIDENTIAL 12
Magellan Health Services, Inc. CONFIDENTIAL 13
Magellan Health Services, Inc. CONFIDENTIAL 14
Magellan Health Services, Inc. CONFIDENTIAL 15
Magellan Health Services, Inc. CONFIDENTIAL 16
Magellan Health Services, Inc. CONFIDENTIAL 17
Magellan Health Services, Inc. CONFIDENTIAL 18
Magellan Health Services, Inc. CONFIDENTIAL 19
Magellan Health Services, Inc. CONFIDENTIAL 20
Magellan Health Services, Inc. CONFIDENTIAL 21
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Magellan Health Services, Inc. CONFIDENTIAL 1
Magellan Health Services, Inc. CONFIDENTIAL 2
Magellan Health Services, Inc. CONFIDENTIAL 3
Magellan Health Services, Inc. CONFIDENTIAL 4
Magellan Health Services, Inc. CONFIDENTIAL 5
12. Early Warning System Report
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
01A INPATIENT PSYCH
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
057284000 BELMONT CTR FOR CMPRHNSV TRTMNT
011127000 BINGHAMPTON GEN HOSP UHS
027766000 BRANDYWINE HOSP
175076000 BROOKE GLEN BHVRL HOSP
600513748 CONEMAUGH VLY MEML MEDCL CTR
135773000 CROZER KEYSTONE MEDCL CTR
058059000 DEVEREUX FNDTN MAINSITE
174296000 FIRST HOSP WYOMING VLY
080769000 FNDTN BHVRL HLTH
059159000 FRIENDS BHVRL HLTH SYST LP
064767000 GNADEN HUETTEN MEMLHOSP 064767000 GNADEN HUETTEN MEMLHOSP
166397000 HOFFMAN HOMES INC
004603000 HORSHAM CLNC MAIN SITE
170049000 INTERCARE
105963000 JACKSON SOUTH CMNTYHOSP
462964000 KIDSPEACE HOSP MAINSITE
189400000 KIRKBRIDE CTR
276713000 LEHIGH VLY HOSP MAIN SITE
057301000 LOWER BUCKS HOSP
004633000 MEADOWS PSYCHC CTR
244096000 MERCY SPECIAL CARE HOSP
463110000 MONTGOMERY CNTY EMER MAIN SITE
024650000 NEWTON MEML HOSP CTR MAIN SITE
600010192 PALMERTON HOSP
086071000 PHILHAVEN MT GRETNAMAIN SITE
Magellan Health Services, Inc. 1
01A
150949000 POCONO MEDCL CTR
219678000 SACRED HEART HOSP
207099000 SCHUYLKILL MEDCL CTR S JACKSON ST
291967000 SOLDIERS AND SAILORS MEML HOSP
187770000 ST LUKES HOSP BETHLEHEM
146542000 ST LUKES HOSP QUAKERTOWN
021246000 UHS OF FAIRMOUNT INC
185848000 WARREN HOSP
057389000 WSTRN PSYCHC INST AND CLNC MAIN
019548000 YORK HOSP MAIN SITE
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
01A INPATIENT PSYCH INPATIENT PSYCH
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
01E EXTENDED ACUTED INPATIENT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
Magellan Health Services, Inc. 2
219678000 SACRED HEART HOSP
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
02 INPATIENT D&A DETOX
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
004418000 EAGLEVILLE HOSP
011427000 VLY FORGE MEDCL CTRAND HOSP
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyS i L l f C b P id (YTD) R t #SV603Service : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
03 PSYCH PARTIAL HOSPITAL
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
260075000 BHVRL HLTH ASSOCS INC
259912000 CARBON LEHIGH IU 21
137711000 CMNTY SVCS GRP INC
207274000 CMNTY SVCS GRP MAINSITE
186648000 COLONIAL IU 20 ADMNSITE
233327000 INNOVATION ST LUKESHOSP CLOSED
Magellan Health Services, Inc. 3
462964000 KIDSPEACE HOSP MAINSITE
061734000 KIDSPEACE NATL CTR INC MAIN SITE
276713000 LEHIGH VLY HOSP MAIN SITE
057182000 LEHIGH VLY HOSP MUHLENBERG
260019000 SALISBURY HOUSE OF NE PA INC
187770000 ST LUKES HOSP BETHLEHEM
261541000 VITALISTIC THERAPEUTIC CTR SITE B
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
04 INPATIENT D&A REHAB
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
004418000 EAGLEVILLE HOSP 004418000 EAGLEVILLE HOSP
011427000 VLY FORGE MEDCL CTRAND HOSP
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
05A NON-HOSPITAL DETOX
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
Magellan Health Services, Inc. 4
Service Dates 1/1/2010 To 12/31/2010
004704000 BOWLING GREEN BRANDYWINE TRTMNT CTR
457845000 CLEAR BROOK LODGE
238664000 CONEWAGO POTTSVILLE
004418000 EAGLEVILLE HOSP
086304000 GAUDENZIA COMMON GROUND
133843000 KEYSTONE CTR
189400000 KIRKBRIDE CTR
057304000 MIRMONT TRTMNT CTR
117418000 PENN FNDTN MAIN SITE
218883000 PYRAMID HLTHCR INC HALF HOUSE
021246000 UHS OF FAIRMOUNT INC
011427000 VLY FORGE MEDCL CTRAND HOSP
004422000 WHITE DEER RUN INC MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010 and Paid Claims Through : 4/30/2011
05B NON-HOSPITAL REHAB
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
600595257 ABRAXAS ERIE ANF FMLY
600595262 ABRAXAS ONE
291959000 ALLENTOWN RESCUE MISSION INC
004704000 BOWLING GREEN BRANDYWINE TRTMNT CTR
457845000 CLEAR BROOK LODGE
230888000 COLONIAL HOUSE
238664000 CONEWAGO POTTSVILLE
600021946 CORNELL ABRAXAS
004418000 EAGLEVILLE HOSP
Magellan Health Services, Inc. 5
235921000 GAUDENZIA INC CTRL REG OFF ADMN
133843000 KEYSTONE CTR
189400000 KIRKBRIDE CTR
774372000 LUZERNE TRTMNT CTR
600595818 MANOS HOUSE
057304000 MIRMONT TRTMNT CTR
203886000 NUESTRA CLINICA OF SACA
117418000 PENN FNDTN MAIN SITE
218883000 PYRAMID HLTHCR INC HALF HOUSE
057203000 TODAY INC
258463000 TRTMNT TRENDS INC MAIN
021246000 UHS OF FAIRMOUNT INC
011427000 VLY FORGE MEDCL CTRAND HOSP
004422000 WHITE DEER RUN INC MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
05C NON-HOSPITAL HALFWAY
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
462430000 ALTRNTV CNSLNG ASSOCS
230887000 CLEM MAR HOUSE INC MEN
235921000 GAUDENZIA INC CTRL REG OFF ADMN
164471000 GOOD FRIENDS INC
167725000 HARWOOD HOUSE
203875000 HEAR INC ADMN SITE
218883000 PYRAMID HLTHCR INC HALF HOUSE
258463000 TRTMNT TRENDS INC MAIN
Magellan Health Services, Inc. 6
004422000 WHITE DEER RUN INC MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
06A PSYCH OUTPATIENT - EVAL/ASSESS/INIT CONSULT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
005298000 CHILD HOSP PHILADELPHIA PRAC ASSN
050126000 CLIFFORD H SCHILKE
210954000 DREXEL UNIV COLG OFMEDCL
600015297 FARHAD SHOLEVAR MD LLC
188794000 GUIDNC PRGM
600250495 INCARE LLC
276713000 LEHIGH VLY HOSP MAIN SITE 276713000 LEHIGH VLY HOSP MAIN SITE
144576000 LEHIGH VLY PHYS GRP
078691000 LENAPE VLY FNDTN MAIN SITE
024650000 NEWTON MEML HOSP CTR MAIN SITE
782411000 READING PRO SVCS
194868000 ST LUKES PSYCHC ASSOC BETHLEHEM
185696000 ST LUKES PSYCHC ASSOCS
173419000 UCHENNA C UZOUKWU
216229000 UNIV OF PITTSBURGH PHYS
094738000 UPPER BUCKS ST LUKES PSYCHC ASSOC
057389000 WSTRN PSYCHC INST AND CLNC MAIN
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton County
Magellan Health Services, Inc. 7
Service : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
06E PSYCH OUTPATIENT - ECT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
057182000 LEHIGH VLY HOSP MUHLENBERG
219678000 SACRED HEART HOSP
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
06K PSYCH OUTPATIENT - MISC OTHER
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
047932000 ABEL A GONZALEZ
078691000 LENAPE VLY FNDTN MAIN SITE
294772000 MATTHEW A BERGER MDPC
486426000 THE NEUROPSYCH GRP
216229000 UNIV OF PITTSBURGH PHYS
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Magellan Health Services, Inc. 8
L
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
06M PSYCH OUTPATIENT - EVAL/ASSESS/INIT CONSULT (98D)
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
047932000 ABEL A GONZALEZ
829555000 ABEL GONZALEZ MD PC
600629695 BERKS PSYCHY INC
600583949 BET EL CNSLNG SVCS PC
260075000 BHVRL HLTH ASSOCS INC
259912000 CARBON LEHIGH IU 21
600404661 CATH CHRT DIOCESE OF ALLENTOWN MAIN
208950000 CONCERN PRO SVCS ADMN
051211000 CORAZON A GUERRA
211123000 COVENANT CNSLNG SVCS
048261000 DAVID W MCGALLIARD
297243000 DIAKON FMLY LIFE SVCS
277484000 DICKINSON CTR INC
210954000 DREXEL UNIV COLG OFMEDCL 210954000 DREXEL UNIV COLG OFMEDC
163271000 ELWYN MAINSITE
456190000 ERIC EUGENE GRIFFIN SHELLEY
806523000 GEORGE JR REPUBLIC IN PA MAINSITE
726322000 GLENN R KOCH AND ASSOCS
188794000 GUIDNC PRGM
712680000 HALL MERCER CMNTY MNTL HLTH
249669000 HAO CNSLNG SVC
260526000 HAVEN HOUSE INC MAIN SITE
280707000 HOLCOMB BHVRL HLTH SYST
199650000 HOLCOMB BHVRL HLTH SYST MAIN
233327000 INNOVATION ST LUKESHOSP CLOSED
157858000 JOSE WILLIAM SANTIAGO
296702000 KAREN A LIVINGOOD
833048000 KIDSPEACE CHILD HOSP INC OPT
Magellan Health Services, Inc. 9
462964000 KIDSPEACE HOSP MAINSITE
154715000 LEHIGH VLY CMHC INC
274376000 LEHIGH VLY HOSP BASE SVC UNIT 392
276713000 LEHIGH VLY HOSP MAIN SITE
078691000 LENAPE VLY FNDTN MAIN SITE
716867000 LIFE GUIDNC LLC
262920000 MATERNAL CHILD CONSORTIUM MAINSITE
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
06M PSYCH OUTPATIENT - EVAL/ASSESS/INIT CONSULT (98D)
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
353238000 METHDST SVCS FOR CHLD AND FMLY MAIN
195268000 NEW DIRECTIONS TRTMNT SVCS 195268000 NEW DIRECTIONS TRTMNT SVCS
600602892 NHS OF MOUNT POCONO
260080000 NHS PA LEHIGH VLY MAIN SITE
203886000 NUESTRA CLINICA OF SACA
600633939 NWN HMN SVCS OF PENNSYLVANIA
117418000 PENN FNDTN MAIN SITE
822609000 PENN PSYCHC CTR INCMAIN SITE
086071000 PHILHAVEN MT GRETNAMAIN SITE
265638000 PINEBROOK FMLY SVCS
272605000 REDCO TURNING POINT
245048000 RICHARD J MILLER
106676000 RIVERSIDE CARE INC ADMN ONLY
134276000 SHARON REGL HLTH SYST MAIN SITE
187770000 ST LUKES HOSP BETHLEHEM
185696000 ST LUKES PSYCHC ASSOCS
Magellan Health Services, Inc. 10
270125000 STEP BY STEP BETHLEHEM
202654000 T W PONESSA AND ASSOCS CNSLNG MAIN
280198000 TIOGA CNTY DEPT OF HMN SVCS
600511738 VALLIERE AND CNSLNGASSOCS INC
802650000 VISIONQUEST NATL LTD ADMN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
06N PSYCH OUTPATIENT - MMHT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
199650000 HOLCOMB BHVRL HLTH SYST MAIN
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
07 BH REHAB CHILD MH/SA
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
216346000 ACCESS SVCS
260075000 BHVRL HLTH ASSOCS INC
259912000 CARBON LEHIGH IU 21
Magellan Health Services, Inc. 11
166035000 CHILD HOME OF READING MAIN
294204000 CMNTY GUIDNC CTR
835232000 CMNTY SOLUTIONS INCMAIN SITE
186648000 COLONIAL IU 20 ADMNSITE
208950000 CONCERN PRO SVCS ADMN
058059000 DEVEREUX FNDTN MAINSITE
163271000 ELWYN MAINSITE
726322000 GLENN R KOCH AND ASSOCS
199650000 HOLCOMB BHVRL HLTH SYST MAIN
296702000 KAREN A LIVINGOOD
462964000 KIDSPEACE HOSP MAINSITE
231281000 MILESTONES CMNTY HLTHCR DEAF SVC
168861000 NATL MENTOR HLTHCR LLC
600528520 NHS OF PA HARRISBURG HOLLIDAYSBURG
476562000 NHS OF PA STROUDSBURG
260080000 NHS PA LEHIGH VLY MAIN SITE
600649474 NWN HMN SVCS OF NEPA
265638000 PINEBROOK FMLY SVCS
057269000 PROGRESSIONS COMPANIES INC
792648000 PSYCHL AND NEUROBHVRL ASSOCS INC
272605000 REDCO TURNING POINT
202654000 T W PONESSA AND ASSOCS CNSLNG MAIN
349914000 TEAM CNSLNG CONCEPTS
135900000 VLY YTH HOUSE MAIN SITE ADMN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
Magellan Health Services, Inc. 12
08 RTF JCAHO
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
166035000 CHILD HOME OF READING MAIN
058059000 DEVEREUX FNDTN MAINSITE
230987000 EIHAB HMN SVCS INC
080769000 FNDTN BHVRL HLTH
166397000 HOFFMAN HOMES INC
170049000 INTERCARE
061734000 KIDSPEACE NATL CTR INC MAIN SITE
353237000 MATERNAL CHILD CONSORTIUM WARWICK
813160000 PENNSYLVANIA CLINICL SCHOOLS CLOSED
169351000 SHAWNEE ACADEMY
169376000 SILVER SPRINGS MARTIN LUTHER SCHOOL
008790000 SOUTHWOOD PSYCHC HOSP
802650000 VISIONQUEST NATL LTD ADMN SITE
086142000 WORDSWORTH ACADEMY FORD RD
Total by LOC (Undup Mbr)
M ll H lth S i N th t C tMagellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
08B RTF JCAHO (SHORT TERM)
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
353237000 MATERNAL CHILD CONSORTIUM WARWICK
169351000 SHAWNEE ACADEMY
Total by LOC (Undup Mbr)
Magellan Health Services, Inc. 13
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
09 RTF NON-JCAHO
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
199650000 HOLCOMB BHVRL HLTH SYST MAIN
260080000 NHS PA LEHIGH VLY MAIN SITE
135900000 VLY YTH HOUSE MAIN SITE ADMN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010d P id Cl i Th h 4/30/2011and Paid Claims Through : 4/30/2011
10A D&A OUTPATIENT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
264368000 CNCL ON ALCHL AND DRUG ABUSE
808325000 GAUDENZIA INC
600532948 HABIT OPCO ALLENTOWN
195268000 NEW DIRECTIONS TRTMNT SVCS
117418000 PENN FNDTN MAIN SITE
829870000 RECVY REVOLUTION INC
106676000 RIVERSIDE CARE INC ADMN ONLY
270125000 STEP BY STEP BETHLEHEM
280198000 TIOGA CNTY DEPT OF HMN SVCS
Magellan Health Services, Inc. 14
258463000 TRTMNT TRENDS INC MAIN
710206000 VLY CNSLNG GRP
004422000 WHITE DEER RUN INC MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
10B D&A OUTPATIENT - METHADONE MAINTENANCE
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
257871000 ADVNCD TRTMNT SYST COATESVILLE
600532948 HABIT OPCO ALLENTOWN
195268000 NEW DIRECTIONS TRTMNT SVCS
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
10C D&A OUTPATIENT - SUBOXONE
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
195268000 NEW DIRECTIONS TRTMNT SVCS
Total by LOC (Undup Mbr)
Magellan Health Services, Inc. 15
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
12 ANCILLARY - LAB
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
164920000 ATLANTIC DGNSTC LABS LLC
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
13 ANCILLARY - CLOZARIL MONITORING
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
207274000 CMNTY SVCS GRP MAINSITE
260526000 HAVEN HOUSE INC MAIN SITE
274376000 LEHIGH VLY HOSP BASE SVC UNIT 392
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010
Magellan Health Services, Inc. 16
and Paid Claims Through : 4/30/2011
14 COMMUNITY SUPPORT - CRISIS
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
208911000 CONCERN PRO SVC
272473000 HORIZON HOUSE MAIN SITE
201974000 LEHIGH CNTY MH MR PRGM
809545000 NEW PERSPECTIVES CRISIS RES TRTMNT
267878000 NORTHAMPTON CNTY CRISIS
094167000 RESRC FOR HMN DEV ADMN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
15 COMMUNITY SUPPORT - FAMILY BASED
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
231281000 MILESTONES CMNTY HLTHCR DEAF SVC
168861000 NATL MENTOR HLTHCR LLC
476562000 NHS OF PA STROUDSBURG
260080000 NHS PA LEHIGH VLY MAIN SITE
265638000 PINEBROOK FMLY SVCS
135900000 VLY YTH HOUSE MAIN SITE ADMN SITE
827478000 WARWICK FMLY BASED PRGM INC
Total by LOC (Undup Mbr)
Magellan Health Services, Inc. 17
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
16A COMMUNITY SUPPORT - ICM
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
835232000 CMNTY SOLUTIONS INCMAIN SITE
163271000 ELWYN MAINSITE
199650000 HOLCOMB BHVRL HLTH SYST MAIN
061734000 KIDSPEACE NATL CTR INC MAIN SITE
201974000 LEHIGH CNTY MH MR PRGM
278442000 LEHIGH VLY ASSERTIVE CMNTY TRTMNT
154715000 LEHIGH VLY CMHC INC
231281000 MILESTONES CMNTY HLTHCR DEAF SVC
168861000 NATL MENTOR HLTHCR LLC
260080000 NHS PA LEHIGH VLY MAIN SITE
600596494 SALISBURY BHVRL HLTH 600596494 SALISBURY BHVRL HLTH
260019000 SALISBURY HOUSE OF NE PA INC
270125000 STEP BY STEP BETHLEHEM
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
16B COMMUNITY SUPPORT - RC
Magellan Health Services, Inc. 18
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
231281000 MILESTONES CMNTY HLTHCR DEAF SVC
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
16C COMMUNITY SUPPORT - CM - OTHER
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
061734000 KIDSPEACE NATL CTR INC MAIN SITE
278442000 LEHIGH VLY ASSERTIVE CMNTY TRTMNT
154715000 LEHIGH VLY CMHC INC
168861000 NATL MENTOR HLTHCR LLC
270125000 STEP BY STEP BETHLEHEM
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
16E COMMUNITY SUPPORT - ENHANCED/CTI
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
278442000 LEHIGH VLY ASSERTIVE CMNTY TRTMNT
260080000 NHS PA LEHIGH VLY MAIN SITE
Magellan Health Services, Inc. 19
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
18 OTHER - PSYCH REHAB
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
260526000 HAVEN HOUSE INC MAIN SITE
231281000 MILESTONES CMNTY HLTHCR DEAF SVC
260019000 SALISBURY HOUSE OF NE PA INC
270125000 STEP BY STEP BETHLEHEM
Total by LOC (Undup Mbr)
M ll H lth S i N th t C tMagellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
19 PEER SUPPORT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
231281000 MILESTONES CMNTY HLTHCR DEAF SVC
168861000 NATL MENTOR HLTHCR LLC
260080000 NHS PA LEHIGH VLY MAIN SITE
600572426 RECVY PRTNRSHP
260019000 SALISBURY HOUSE OF NE PA INC
Magellan Health Services, Inc. 20
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98A OTHER - D&A PARTIAL
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
004422000 WHITE DEER RUN INC MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
S i D t 1/1/2010 T 12/31/2010Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98D OTHER - MH OUTPATIENT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
064760000 ALBERT EINSTEIN MEDCL CTR
155702000 AMERCN MEDCL AND NEUROPSYCHC SVC
545566000 ANN E GAULIN
600614052 CMNTY CNSLNG SVCS OF NE PA
051211000 CORAZON A GUERRA
211123000 COVENANT CNSLNG SVCS
229548000 DEBORAH J MIKITA
210954000 DREXEL UNIV COLG OFMEDCL
Magellan Health Services, Inc. 21
Service Level of #SV603
456190000 ERIC EUGENE GRIFFIN SHELLEY
600015297 FARHAD SHOLEVAR MD LLC
455734000 FITZMAURICE CMNTY SVC
726322000 GLENN R KOCH AND ASSOCS
723785000 HOSP OF THE UNIV OFPA
296702000 KAREN A LIVINGOOD
600248384 KATHLEEN COUGHLIN LSW AND ASSOCS
078691000 LENAPE VLY FNDTN MAIN SITE
052715000 NEVILLE H KOTWAL
219678000 SACRED HEART HOSP
346264000 SHAFIQ UR RAHMAN
185696000 ST LUKES PSYCHC ASSOCS
196055000 TEMPLE UNIV HOSP
600511738 VALLIERE AND CNSLNGASSOCS INC
185848000 WARREN HOSP
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603 : Care by Provider (YTD) Report
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98F OTHER - RESID & HOUSING SVCS (MH)
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
600069200 PROJECT TRANSITION SINKING SPRING
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Magellan Health Services, Inc. 22
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98G OTHER - IOP D&A CLINIC
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
195268000 NEW DIRECTIONS TRTMNT SVCS
710206000 VLY CNSLNG GRP
004422000 WHITE DEER RUN INC MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98H OTHER - MH PRACTITIONER
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
600072282 ALLNCE CNSLNG AND WELLNESS
545566000 ANN E GAULIN
811566000 CAROL W HAUPT
566729000 CHRISTINE L CATANIA RACHLIN
600634532 CORNERSTONE CNSLNG AND CONSLTNG S
828776000 CREATIVE PATHWAYS CNSLNG
161664000 FMLY ANSWERS
188794000 GUIDNC PRGM
792235000 JOANNE E MATTHEWS
586442000 JOANNE T NIGITO RAFTAS
600248384 KATHLEEN COUGHLIN LSW AND ASSOCS
292404000 KATHLEEN E COUGHLIN
Magellan Health Services, Inc. 23
600602625 MIGDALIA ROMAN
600002842 THERESA APPLEGARTH
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98J OTHER - D&A SCA DIAG ASSESSMENT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
010418000 LEHIGH VLY DRUG ANDALCHL INTAKE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyS i L l f C b P id (YTD) R t #SV603Service : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98L OTHER - D&A TARGETED CASE MANAGEMENT
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
010418000 LEHIGH VLY DRUG ANDALCHL INTAKE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Magellan Health Services, Inc. 24
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98N OTHER - COMMUNITY TREATMENT TEAMS
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
163271000 ELWYN MAINSITE
278442000 LEHIGH VLY ASSERTIVE CMNTY TRTMNT
260080000 NHS PA LEHIGH VLY MAIN SITE
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
98U OTHER - TOBACCO CESSATION
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
195268000 NEW DIRECTIONS TRTMNT SVCS
Total by LOC (Undup Mbr)
Magellan Health Services - Northampton CountyService : Level of Care by Provider (YTD) Report #SV603
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
Magellan Health Services, Inc. 25
Grand Total
Provider Name # Undup Clients
# Units of Svc $ Paid Unit Per
Client $ Per Client $ Per Unit Units Per 1000 $ Per 1000
Total (Undup Mbr)
© Magellan Health Services, Inc. | ASD (Newtown, PA) | Last revision - 9/11/2007.
Magellan Health Services, Inc. 26
05C HALFWAY
Magellan Health Services - Northampton CountyService : Level of Care Demographic Summary (YTD)
Report #SV607
Service Dates 1/1/2010 To 12/31/2010and Paid Claims Through : 4/30/2011
Age(duplicated)
on claim begin date 1
Level Of Care Total UndupClient
Total $ 0-5 12-Jun 13-17 18-21 22-44 45-64 65+ TANF
01A INPATIENT PSYCH
01E EXTENDED ACUTED INPATIENT
02 INPATIENT D&A DETOX
03 PSYCH PARTIAL HOSPITAL
04 INPATIENT D&A REHAB
05A NON-HOSPITAL DETOX
05B NON-HOSPITAL REHAB
05C NON-HOSPITAL HALFWAY NON-HOSPITAL
06 PSYCH OUTPATIENT
07 BH REHAB CHILD MH/SA
08 RTF JCAHO
08B RTF JCAHO (SHORT TERM)
09 RTF NON-JCAHO
10A D&A OUTPATIENT
10B D&A OUTPATIENT - METHADONE MAINTENANCE
10C D&A OUTPATIENT - SUBOXONE
12 ANCILLARY - LAB
13 ANCILLARY - CLOZARIL MONITORING
14 COMMUNITY SUPPORT - CRISIS
15 COMMUNITY SUPPORT - FAMILY BASED
16A COMMUNITY SUPPORT - ICM
16B COMMUNITY SUPPORT - RC
Magellan Health Services, Inc. 27
16C COMMUNITY SUPPORT - CM - OTHER
16E COMMUNITY SUPPORT - ENHANCED/CTI
18 OTHER - PSYCH REHAB
19 PEER SUPPORT
98A OTHER - D&A PARTIAL
98D OTHER - MH OUTPATIENT
98F OTHER - RESID & HOUSING SVCS (MH)
98G OTHER - IOP D&A CLINIC
98H OTHER - MH PRACTITIONER
98J OTHER - D&A SCA DIAG ASSESSMENT
98L OTHER - D&A TARGETED CASE MANAGEMENT
98N OTHER - COMMUNITY TREATMENT TEAMS
98U OTHER - TOBACCO CESSATION
Total (Undup Mbr)
Magellan Health Services, Inc. 28
Categories of Aid
2 3 4 5 6 7
Healthy Beg. SSI W Mdcr SSI W/O Mdcr Gen. Ass. State GA
Med. NeedyFed Ass.
MA/GA Rec.
Magellan Health Services, Inc. 29