magellan provider claims phone number

Provider contacts Important contact information. There is a simple testing process to determine if Direct Submit is right for you. Attn: Recommended Clinical Reviews Go directly to an emergency room. Electronic claims filing system, Benefit disclosure information (form available online), Recommended Clinical Review (RCR) Requests (formerly Predeterminations ), Online: Use Availity Attachments application, Mail RCRform to: Q. Designed by Elegant Themes | Powered by WordPress, https://cccm.thinkculturalhealth.hhs.gov/. 1-361-878-1623 Q. I recently joined the Magellan provider network. 1001 E. Lookout Drive Magellan continuously looks at our processes and procedures to improve service and increase efficiencies. Direct Submit supports HIPAA 837P and 837I claims submission files. Copy of an EOP with a date within the timely filing period, Certified or overnight mail receipts dated within the timely filing period, Copy of the claim with Magellan's date stamp within the timely filing period, Copy of 2nd level EDI 277 acceptance reports. Claims are paid based on your status on the date of service. One option is Adobe Reader which has a built-in reader. Box 660044 BlueCard is our out-of-area program that allows members from other Blue Cross and Blue Shield Plans to receive health care benefits when travelling or residing in another Blue Plan's service area. Magellan is not responsible for paying claims, you will need to contact the Governor Northam recently announced the creation of a Task Force on Primary Care in partnership with the Virginia Center for Health Innovation (VCHI) and Secretary of Health and Human Resources Daniel Carey. No. Necessary information Please log onto https://cccm.thinkculturalhealth.hhs.gov/ for various educational sessions regarding culturally competent care. El Paso, TX 79912 -6156 Providers can access myPRES 24 hours a day, seven days a week. With the increasing diversity of our population, physicians are becoming more likely to encounter situations that require the delivery of culturally competent care, access to a variety of foreign language services and also supportive health care organizations. endobj Dallas, TX 75266-0241 No. Independence Blue Cross is a subsidiary of Independence Health Group, Inc. independent licensees of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania, Sitemap | Legal | Privacy & other policies | Anti-fraud | Developer resources, Language access: Espaol | / | Tagalog | Franais | Ting Vit | Deutsche | | | | | | | Italiano | Portugus | Kreyl | Jzyk | Polski | | Pennsylvania Deitsch | | Din bizaad, The widest choice for quality care in the region, Comprehensive plans for every business size and budget, Affordable Medicare health and prescription drug plans that meet your needs, Find a particular provider, specialist, hospital, or specialty facility, Understand and maximize your prescription drug benefits, Resources to support your behavioral, physical and emotional health, Exclusive programs and tools designed to help you live a healthier life, Free classes and seminars for IBX members, Convenient online resources and services for our groups, Everything you need to sell Independence Blue Cross, Find doctors, hospitals, medical equipment, and specialty services, Children's Health Insurance Program (CHIP), Critical illness, accident, and cancer insurance, Critical illness, accident and cancer insurance, Uprise Health Employee Assistance Program, Precertification and cost-share requirements, Medical policy and precertification inquiry, Provider communications email sign up form, Claims requiring submission of clinical information, Independence Provider Network Services (PNS) team contact, Provider Communications Email Sign-up Form, Precertification requests for CT/CTA, MRI/MRA, PET, nuclear cardiology, facility setting sleep studies, continuous positive airway pressure titration, sleep equipment (APAP, BPAP, CPAP) and related supplies, Cardiology Utilization Management Program, and Musculoskeletal Utilization Management Program, Precertification requests for nonemergent outpatient radiation therapy services Precertification and/or prepayment reviews for genetic/genomic tests, certain molecular analyses, and cytogenetic tests. Magellan Healthcare, Inc. DO NOT COMPLETE THIS FORM IF YOU ARE A MAGELLAN COMPLETE CARE MEMBER OR PROVIDER. ), For services managed by Magellan: Provider Websites and Secure Portals | Magellan Healthcare Click to skip to content. AmeriHealth There are several reasons claims may not be paid upon their first submission. Contact. Fax: 1-800-424-5881. . Coverage issued by AmeriHealth HMO, Inc. and/or AmeriHealth Insurance Company of New Jersey. Magellan Health, Inc. | Providers | User Sign In - Magellan Provider 1-800-749-0966 Click to skip to content, You are on secondary menu. File a Claim | Magellan of PA A Claims Courier Demo can be accessed at: Claims Courier is a free web-based data entry application. A. Medicaid Provider Enrollment Unit Gainwell Technologies P.O. By enforcing the timely filing requirement in the provider contract, we are able to focus our resources on what our providers have asked us to do - promptly pay claims. Magellan of Louisiana. Q. I did not submit a claim due to a change in coverage for the member in question. For information regarding the different options for checking EVS, click here to go to the DHS website or call 1-800-766-5387 for interactive (real-time) eligibility verification (24/7). New Jersey residents and businesses can choose from a wide selection of AmeriHealth health plans. If Magellan is not responsible for paying claims, you will need to contact the claims payer directly for claims information. Where do I send the claim information?A. Bucks County: (877) 769-9784; Cambria County: (800) 424-0485; Lehigh County: (866) 238-2311; Montgomery County: (877) 769-9782; Northampton County . Please note: as these requirements can be subject to change, thegrid may not contain a complete list of exceptions. Email to submit provider inquiries and questions, Blue Cross and Blue Shield of Texas What should I do? Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Cornel Hubbard, J.D., CCEP | Vice President and General Manager, Danyelle Dutton Smilovich | Provider Relations Director, Dr. Stephen Towns, DSL, MDiv, PMP, CSM | Director Project and Program Management, Tina Bodkins, MA, LCSW | Director of Quality, Tricia Van Rossum, Ph.D., LCSW, CSOTP | Director of Clinical Care Services, You are on primary menu. 1999-2023 Magellan Health, Inc. All Rights Reserved. This practice is called balance billing and is not permitted. Below you will find links to all Magellan provider websites and secure portals. Registration is a means of notifying Magellan of Virginia that an individual will be . Q. I have never had a claim denied for timely filing reasons before; why is it being denied now?A. providers as described in any contract between a provider and Magellan. For Medicaid individuals who are enrolled in the Commonwealth Coordinated Care Plus (CCC Plus) Program, DMAS is preparing to transition the Community Mental Health Rehabilitation Services (CMHRS) into the CCC Plus managed care organization (MCO) contract effective January 1, 2018. This claim is a resubmit; why was it denied for timely filing?A. Contact Availity or other electronic connectivity vendor or call Magellan Behavioral Health 1-800-729-2422, Carelon Medical Benefits Management (Carelon), Claim filing address for Commercial products, Availity Essentials Cardiology Utilization Management Program, and Musculoskeletal Utilization Management Program. See key details from the, Claims/ Check Eligibility/ View Authorizations, You are on primary menu. 4 0 obj Phone: 1-713-354-7033 Provider contracting questions: Contact your Magellan Healthcare Area Contract Manager or the Radiology Network Services line at 1-800-327-0641. Magellan of Virginia Under Magellan's policies and procedures, the standard timely filing limit is 60 days (with a few state/plan exceptions ). Provider Services (direct all inquiries or issues directly to Independence Administrators) 1-888-356-7899: Independence Blue Cross and Highmark Blue Shield Caring Foundation Hotline: 1-800-464-5437: Keystone First Hours: Mon. Providers Claims | Presbyterian Health Plan, Inc. Arboretum Plaza II 259 Prospect Plains Road, Bldg. Credentialing and re-credentialing application status inquiries, Prescription drug prior authorization 24 hours a day, 7 days a week, Provider Services (direct all inquiries or issues directly to Independence Administrators), For Keystone Health Plan East Members with Caring Foundation benefits. #"MIf"W,I%/Y\VG7AgJk&0ODM e:YV%SC Magellan encourages our providers to submit electronic claims. Providers under contract with Magellan of Virginia should consult the National Provider Handbook, the Virginia Provider Handbook or contact Magellan of Virginia at 800-424-4536 Medi-Cal Rx Contact Information Medi-Cal Rx Phone and Fax Information The Medi-Cal Rx Customer Service Center is available 24 hours a day, 7 days a week, 365 days per year. Houston, TX 77027-3279 into the adjudication system and will remain in Claims Inquiry for 18 months. Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services mental health and chemical dependency prior authorization and referrals (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services) call 1-800-528-7264, Behavioral health services claims status inquiries contact Availity or other electronic connectivity vendor or call 1-800-442-4607*, Behavioral health services claim adjustments call 1-800-442-4607, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-877-299-2377*, Claim status inquiries contact Availity or other electronic connectivity vendor, Medical Management Correspondence for the Health Insurance Marketplace for Blue Advantage HMO Members, Blue Cross Blue Shield of Texas No. PDF Magellan Complete Care of Virginia - Virginia Association of Community Box 660027 Or call your doctor or therapist for help. endobj Box Information Need to Mail: Send to: . Visit our Member Site. Fax: 713-663-1227 Magellan Rx Management Pharmacy Call Center: 1-800-424-5725. Ensure corrected claims get paid Remember to include the appropriate qualifier and original claim number on corrected claims (CMS 1500 and UB-4). Legal | Privacy | Anti-fraud | Developer resources | Transparency in coverage, Language access services: Espaol | / | Lus hmoob | Vietnamese Ting Vit | | | | Franais | Deutsche | | | | Tagalog | Din Bizaad | | Italiano | | Polski | Kreyl | Portugus | | | | | | Kiswahili | Anishinaabemowin Note: For the requests below, utilize the indicated links: All other inquiries submit an email by selecting the office closest to your location and provide the Tax Identification Number, NPI, and if applicable, Medicare Numbers for your provider when contacting Network Management. Notice of Nondiscrimination, Behavioral, physical, and emotional health, Find doctors, hospitals, medical equipment, and specialty services, Provider Services (Direct all inquiries or issues) directly to AmeriHealth Administrators, Precertification requests for CT/CTA, MRI/MRA, PET, nuclear cardiology, facility and home-based setting sleep study, continuous positive airway pressure titration, sleep equipment (APAP, BPAP, CPAP) and related supplies Contact your designated Independence Provider Network Services (PNS) team contact. For more information and additional contacts, please see our FAQs. Governor Northam recently announced the creation of a Task Force on Primary Care in partnership with the Virginia Center for Health Innovation (VCHI) and Secretary of Health and Human Resources Daniel Carey. Find links to Magellan and NIA Magellan provider websites and portals here 10 things to check each time you submit a claim: Q. I believe I am being paid the incorrect rate. Fax: 512-349-4853 Provider Search | Magellan Healthcare This new site may be offered by a vendor or an independent third party. If claims are submitted after the timely filing limit, they will be denied for payment, subject to applicable state and federal laws. The Magellan timely filing standards (or in accordance with your state law) will be applied to claims for services rendered after you joined the Magellan network. MCranbury, NJ 08512-3706 Electronic claims filing allows for earlier detection of errors and drastically reduces the likelihood of claims being rejected or denied for payment, and often results in faster processing. Please submit all paper claims to: Alliant Health Plans PO Box 2667 Dalton, GA 30722 Client Services: Toll free (TTY/TDD) (800) 811-4793. #LPw!4B"5JHImu#14^\;l ~F @hId ye9c2_aq.`;mPp kY,4a9i)S'\6jQxa:_x this message tool is for media inquiries only. 1001 E Lookout Drive ~O@ Philadelphia, PA 19103-1480. All claims for covered services provided to HealthChoices Members must be submitted to and received by Magellan as follows: Within sixty (60) days from date of service for most levels of care except as provided below; Within sixty (60) days from date of discharge for 24/hr level of care; Within sixty (60) days of the last day of the month or the discharge date, whichever is earlier when billing monthly for longer treatment episodes of care at a 24/hr level facility; Within sixty (60) days of the claim settlement for third party claims. To ensure fast and accurate service, if you are a Magellan member, customer, provider or otherwise . Clean claims are defined as claims that can be processed without obtaining any additional information from the provider or from a third party. Resubmission of Claims: Claims that must be revised and resubmitted after adjudication must be stamped resubmission or otherwise noted on box 22 of the CMS-1500 form. Blue Cross and Blue Shield of Texas For exceptions to the standard timely filing requirements for specific states and/or plans/programs, refer to your contract withMagellan and/or its affiliates; see theMagellan state-, plan-and EAP-specific handbook supplements; refer to our timely filingexception grid; or consult state and federal laws. Find answers to your top questions. endobj Contact Us Toll Free: 888-762-8633. BCBSTX Behavioral Health Unit A. Fax: 1-713-663-1227 Find your provider portal Fax: 361-852-0624 Contact us | Providers | Independence Blue Cross (IBX) PDF Provider Manual Title: Residential Treatment Services Revision Date: 1 Providers should send claims to the address indicated on the Read thepress releasefor more information. 2n@*ZFqZj"ea96cmP0nIE#V+_O=_2~^+7W.Q Xc ZD)?>Zm8HBwYJ Blue Cross and Blue Shield of Texas The Task Force's goal is to find solutions and support for providers during the COVID-19 pandemic. Manager, Service Operations QEN Magellan of Florida Office: 407-374-5420 or 800-562-4059 Fax: 888-656-6823. You may also check eligibility by calling Magellan's . Claims for services provided to HealthChoices Members who have another primary insurance carrier must be submitted to the primary insurer first in order to obtain an EOB. Customer Service and Precertification 24 hours a day, 7 days a week: 1-800-809-9954 (NJ) 1-800-688-1911 (PA) External link You are leaving this website/app (site). This means that, subject to applicable state or federal laws, claims must be submitted toMagellan within 60 days of the date of service or inpatientdischarge. Members Page | Magellan of PA Q. I have a specific question about a claim. At Magellan Rx, we are providing a smarter approach to pharmacy benefits. Fax: 361-852-0624 All non-EAP claims paid by Magellan are available through Claims Inquiry. x]o8@}"(Eits@n`a9Vj;)zfLIvlnCN]1Yok9 >9X~,gb=_bZ.wNX0JX,qI Y}$WQp/^{qg?Wyr1NG`,F+L/ Dallas, TX 75266-0027, Prior authorization of Medical Services for the Health Insurance Marketplace for Blue Advantage HMO Members, Eligibility and benefits contact Availity or other electronic connectivity vendor or call 1-800-451-0287*, Behavioral health services mental health and chemical dependency, For prior authorization and referrals managed by BCBSTX: (includes inpatient, residential treatment center (RTC) programs, partial hospitalization and outpatient behavioral health services). Resubmitted claims should include the Date of Original Submission and Claim number if applicable. Austin, TX 78759-7228 1-800-637-0171, press 3 or 1-713-663-1149 Behavioral Health Program Members This link will take you to the Registration and Sign In page on the MagellanAssist.com website. . What should I do? Availity provides administrative services to BCBSTX. Give us a call at Behavioral Health | Yale Health Types of claims | Necessary information | more. Upon receipt of a claim, Magellan reviews the documentation and makes a payment determination. Email Us. 1901 Market Street 1-800-336-5696 M into the system, and there often is a minimal time lag between when the claim stream You are responsible for verifying the member's coverage at the time of service. Checking Claim Status The easiest way to check the status of a claim is through the myPRES portal. Magellan Behavioral Health Providers of Texas, Inc. 1-800-729-2422: Behavioral health services - claims status inquiries . Media Inquiries | Magellan Health Eligibility and benefits Login to myPRES to Check Status For this reason, your resubmitted claim has been denied. Provider Focus - Contact Us Fax: 1-713-663-1227 B3+R}[=y]0{?. Customer Service Rep II Contact DMS - Arkansas Department of Human Services . Dallas, TX 75266-0044, Behavioral health services - claims status inquiries, For services managed by BCBSTX: Our claims filing procedures are listed in detail in Section 5 of the Magellan National Provider Handbook (PDF). Call 1-800-528-7264 or the phone number listed on the back of the member's/subscriber's ID card. Claims Filing Procedures Magellan is committed to reimbursing our providers promptly and accurately. Copyright 2023. Under Magellan's policies and procedures, the standardtimely filing limit is 60 days. *interactive voice response (IVR) system to access, you must have document control number (claim number), Blue Cross and Blue Shield of Texas Medicaid. Its similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant. Email Us | Back to Top Necessary information Users will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes. Typically, a fee is attached by the clearinghouse vendor. It is important that you review all EOPs promptly. We can also tell you if the provider is currently accepting new . For the latest information on the novel coronavirus (COVID-19) please visit: Quality behavioral health services delivered to Virginia Medicaid enrollees. Yes. Provider Frequently Asked Questions (FAQ) - Magellan of Virginia pS1ZP/+q6LK1[]\D:tNnN,kcKrySAG~Bw!h,zy a57f!d{R-GO*`c|99.G"?Q[YZS 3j Enforcing this clause also brings us in line with industry practices. 1-915-496-6600, press 2 *interactive voice response (IVR) system to access, you must have document control number (claim number), Eligibility and benefits contact your electronic connectivity vendor, Availity or other electronic connectivity vendor or call 1-800-451-0287*. 1 0 obj Medicaid Network Management Email to submit provider inquiries and questions. Please note that registration is necessary for claims to be paid. Click to skip to content. <> Richardson, TX 75082 Website Support: To request a username, reset a password or ask questions about this website, or if you experience any technical issues with the site, contact our Provider Services Line at 1-800-788-4005 Monday - Friday from 8:00 a.m. to 5:30 p.m. Central Time. 1-713-663-1149 BlueCard 3 0 obj

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