PROVIDERS
Modern Assistance maintains an extensive Preferred Provider Network of community and agency based Psychiatrists, Psychologists, Psychiatric Nurse Practitioners, Marriage and Family Therapists, Licensed Mental Health Counselors, Licensed Social Workers and Licensed Alcohol and Drug Counselors.
We have a comprehensive network of inpatient, partial hospitalization and intensive outpatient providers across New England for psychiatric and substance abuse treatment.
Are you an existing provider?
Medical Necessity
Modern Assistance utilizes Magellan Care Guidelines for the determination of Medical Necessity. These criteria are applied in the context of other critical issues, such as an individual’s psychosocial needs, desired outcomes, access to community resources, and coordination of care between behavioral health, physical health, specialty providers, and other systems of care. The goal of these criteria is to promote recovery from the symptoms of mental illness and substance use disorders and to support the Member’s stabilization at the highest level of functioning.
Level of Care Determinations
For question on the medical criteria used to make a level of care determination,
Please contact our Clinical Director
Courtney Daruszka, M.S, LMHC
Please note, Modern Assistance seeks to make placements in a level of care that is the least restrictive and most clinically appropriate service or level of care to safely, effectively, and efficiently meet the needs of the patient.
Provider Forms
If you are an Existing Provider, please utilize our Provider Forms section for accessing documentation necessary for obtaining initial and concurrent outpatient mental health or substance abuse authorizations.
Are you a new provider?
Professional Credentialing
Are you an outpatient mental health or substance abuse provider interested in joining the Modern Assistance Preferred Provider Network?
Our streamlined process allows qualified providers to join our Preferred Provider Network in less than 48 hours. Providers must send the following information by fax or mail in order to have their credentials reviewed and a network determination made.
- NPI (National Provider Identification) number.
- Federal Tax Identification number.
- Copy of Providers most Professional Liability Insurance (Declaration Page).
- Copy of Providers License.
- Contact Information including address for which payments can be sent.
Fax or email the previous information or for any questions regarding the network determination process,
Please contact our Operations Administrator
Michelle Murphy
Facility Credentialing
Do you represent a facility or agency interested in contracting with Modern Assistance for inpatient, partial hospitalization or intensive outpatient psychiatric or substance abuse services
Facilities seeking to contract with Modern Assistance for inpatient, partial hospitalization or intensive outpatient programs for substance abuse or mental health must be licensed and certified within their state of operation.
Please note that Modern Assistance conducts site visits as a prerequisite to any contract. A single case agreement with Modern Assistance does not constitute grounds for contract development.
To discuss credentialing and contracting details,
Please contact our Vice President
Damien J. Turini, M.S., M.A., LADC1
Claims
Claim Processing
All psychiatric and substance abuse claims for inpatient, partial hospitalization and intensive outpatient treatment must be accompanied by the clinical discharge report in order to be processed.
Claims may be sent by mail or fax
Mail Claims
Modern Assistance
Claims Department
1400 Hancock Street, 2nd Floor
Quincy, MA 02169
Fax Claims
Modern Assistance
Attn: Claims Department
617-774-0336
To Check Status of a Claim
Inquiries for Claim Status must be sent by email to, claims@modernassistance.com.
The following information must be included with your inquiry:
- Billing and/or Provider Name
- Billing and/or Provider Phone Number
- Client Name
- Client DOB
- Dates of Service
- Service Type (CPT Code or Description)
Claim Status inquiries will be responded to within 3 business days.