Magellanprovider.com
Magellan Provider's Home Page
WEBMagellan Health Services is a specialty health care management company that delivers innovative solutions in collaboration with health plans, corporations and
Actived: 1 days ago
URL: https://www.magellanprovider.com/MagellanProvider/do/LoadHome
Change Healthcare outage
WEBOn Feb. 21, 2024, Change Healthcare a software and data analytics subsidiary of UnitedHealth Group’s Optum unit, and vendor of Magellan Health (Magellan), experienced a cybersecurity incident that has impacted its network and operations. The cybersecurity incident has created service disruption that has impacted payers, providers and
Contact Us FAQs Claims Submission
WEBOnly participating providers can obtain a secure log in to access the online claims submission application Claims Courier. If you are a non-participating provider, and would like to become a participating provider, please contact the Network Representative in your state for information and to request an application.
Telehealth Provider Frequently Asked Questions
WEBAs a Magellan provider, you will continue to verify benefits and eligibility, as well as submit claims, exactly as you do now. Note: You must bill using the “GT” or “95” modifier to signify telehealth services. Claims should also include the telehealth place of service code “02.”. Telehealth services must be a covered benefit under
Active Network Providers
WEBMagellan providers are licensed and credentialed to high industry standards and have documented experience in the treatment of mental illness and/or substance abuse. Network providers must: Be both credentialed and contracted with Magellan. Become recredentialed every three years, unless otherwise required by a customer or applicable law. Cooperate …
Contact Us FAQs
WEBAll members whose behavioral health care services are managed by Magellan will be available through Eligibility Inquiry except some EAP members and member information that is available only in our customer's eligibility systems. If you believe that the member's care is managed by Magellan and are unable to verify eligibility online or you
Contact Us FAQs Claims Submission
WEBClaims are generally available in Claims Inquiry one day after they are entered into the adjudication system and will remain in Claims Inquiry for 18 months. Please note, claims must be formatted correctly before they can be entered into the system, and there often is a minimal time lag between when the claim is submitted and when it is entered
Magellan Care Guidelines 2022-2023
WEBMagellan uses MCG Guidelines®, along with its proprietary clinical criteria, Magellan Healthcare Guidelines, as the primary decision support tools for our Utilization Management Program. Collectively, they are known as the Magellan Care Guidelines. Magellan uses The ASAM Criteria® and other state-developed guidelines for management of
HEDIS® measures
WEBMedical literature shows that aftercare reduces the rate of. 18% of adults and 13-20% of children under 18 experience mental illness. Follow-up care results in fewer repeat ED visits. It improves physical and mental function. It results in better compliance with both behavioral and physical issues. avoidable readmissions.
National Provider Identifier
WEBA: The National Provider Identifier (NPI) is a 10-digit number required on all HIPAA standard electronic transactions. NPIs have replaced all separately issued identifiers, including Medicaid PINs, Medicare UPINs and health plan-assigned identifiers, on HIPAA standard electronic transactions. The NPI was put in place so that each provider has
California Quick Reference Guide
WEB1-800-750-4776. Clinical. 1-800-424-4134. Claims Mailing Address. PO Box 710520 San Diego, CA 92171. Appeals. Health Plan of San Mateo ATTN: Claims Department 801 Gateway Boulevard South San Francisco, CA 94080. 2017-2024 Magellan Health, Inc. 11/23 In California, Magellan does business as Human Affairs International of California, …
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