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Click ‘Get Form’ to open it in the editor.
Begin by filling in your Individual or Group MIS# at the top of the form. This is essential for identification within Magellan's system.
In Section I, provide your personal details including Last Name, First Name, Date of Birth, and Gender. Ensure accuracy as this information is crucial for processing.
Complete the License Type and License# fields. If applicable, include your Medicaid ID# and NPI# (Type 1).
Fill out your mailing address and primary practice address accurately. This ensures that all correspondence reaches you without delay.
If you are a group member, indicate the Group Name and answer whether you have been employed by Magellan before.
In Section II, if applicable, provide details about your Group/Organization including NPI (Type 2) and contact information.
Finally, review all sections for completeness before submitting the form along with a completed W9 via fax to ensure prompt processing.
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Magellan partners with the states of Florida, Idaho, Louisiana, Nevada, New Mexico and Wyoming and local governments in Pennsylvania to manage behavioral health services for more than a million Medicaid beneficiaries.
How do I check my Magellan eligibility?
Call us at 1-833-396-4310 (TTY 711). Parents, caregivers, teachers, counselors and mental health professionals can refer a child/young adult to be screened for eligibility. Young adults can also refer themselves as well.
Is Blue Shield the same as Magellan?
Blue Cross Blue Shield (BCBS) is a health insurance provider, while Magellan Health specializes in behavioral health services. They are separate entities but often work together to provide comprehensive healthcare coverage.
Does Magellan RX offer clinical programs?
Visit Magellan Rx for more information. We help our customers and members solve complex pharmacy challenges by connecting them to the people, technology and information they need to make smarter healthcare decisions. We deliver true value-driven solutions, including: Targeted clinical programs.
What is the payer ID for Magellan Idaho?
You must submit claims with payer ID 01260 and claim office ID PO Box 1029. We strongly encourage all providers to submit claims to Magellan electronically via one of the methods above; however, if you opt to file on paper, submit claims to: Magellan Healthcare, Inc.
Related Searches
Magellan provider phone numberMagellan behavioral Health provider portalMagellan Prior Authorization Form PDFMagellan provider EnrollmentMagellan provider credentialing phone numberMagellan prior authorization PortalMagellan provider websiteMagellan provider phone number for eligibility
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You must submit claims with payer ID 01260 and claim office ID PO Box 1029. We strongly encourage all providers to submit claims to Magellan electronically via one of the methods above; however, if you opt to file on paper, submit claims to: Magellan Healthcare, Inc. P.O. Box 1029 Maryland Heights, MO 63043.
How does Magellan RX handle prior authorizations?
If, within 30 days, the submitting provider sends the additional information and it establishes medical necessity, Magellan will take appropriate action to approve the PA request, and notification will be sent back to the submitting provider confirming that the PA request has been approved.
How do I verify my Medicaid provider eligibility in Louisiana?
The Medicaid Eligibility Verification System (MEVS). Providers can accept verification of enrollment in Louisiana Healthcare Connections from the MEVS system in lieu of the ID card. Online through our secure provider portal. By phone using our automated IVR system, 1-866-595-8133.
Related links
Call 1-800-523-5668
Provider SearchGet the names of and locations of providers online My Topics Select the topics that youre most interested in getting information on.
Complete and Return an Interested Provider Form. Please include all requested supporting documentation as it is required for credentialing. Once you have
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