Magellan Health

For Providers

Submit Claims

Accepted Methods for Claims Submission

  1. Electronic Data Interface (EDI) via Direct Submit
  2. Claims Courier - Magellan's Web-based Claims data-entry submission tool
  3. EDI via a third-party clearinghouse
  4. Paper Claims - CMS-1500 (non-facility-based providers) or UB-04 (facility-based providers)
 
EDI via Direct Submit:
  • Direct Submission is free to providers.
  • Provider sends HIPAA transaction files directly to and receives responses from Magellan without a clearinghouse.
  • Direct Submit supports HIPAA 837P and 837I claims submission files.
  • If you are able to create an 837 file in a HIPAA compliant format, we recommend EDI Direct Submission.
  • A simple testing process helps determine if Direct Submit is right for you.
    • EDI Testing Center: www.edi.magellanprovider.com
    • Self-enroll by creating a unique user ID and password
    • Go through the simple six-step process that includes uploading and sending test files. You will obtain immediate feedback regarding the results of the test to ensure compliance with HIPAA rules and codes.
    • We will assign you an IT analyst to guide you through the process and address any questions.
    • It typically takes 3 to 4 weeks to complete the process, so allow ample time to complete your independent testing.
    • EDI Support: Contact Magellan's EDI Hotline for support and/or assistance: 1-800-450-7281 ext. 75890 or the EDI Support Mail Box: EDISupport@magellanhealth.com
 Claims Courier:
  • To submit claims on Magellan's website using the Claims Courier application, sign in to the Magellan provider website with your secure username and password. Under My Practice, go to "Submit a Claim Online."
  • You may access a Claims Courier “Submit a Claim Online” demo on the Online Training page of the provider site.
  • Claims Courier is a free Web-based data-entry application. It's similar to the CMS 1500 claim form, with additional fields to make the application HIPAA-compliant.
  • Magellan recommends Claims Courier for low-volume claim submitters.
  • Claims Courier is an 837P compliant application. Therefore it does not support revenue codes (codes submitted on 837I files or a UB-04).
EDI via Third-Party Clearinghouse:
  • Through this option, providers submit to a third party "middle-man" who in turn submits HIPAA-compliant 837 files to Magellan.
  • Typically, a fee is attached by the clearinghouse vendor.
  • Magellan has a list of preferred clearinghouse vendors
Paper Claims:
  • Although it is not preferred, providers also may submit paper claims via a CMS-1500 form (non-facility-based providers) or UB-04 form (facility-based providers).
  • Paper claims must be submitted to the below address (claims are not accepted at the Magellan of Virginia Call Center):
    • Magellan Behavioral Health, PO Box 1099, Maryland Heights, MO 63043
Return to Top

Contact Us

Magellan Members
Toll-free:1-800-424-4046
TDD: 1-800-424-4048
TTY: 711
Email

Magellan Providers
For questions about credentialing, contracting, provider website issues or general provider concerns, please contact us or call 1-800-424-4536.

For claim, authorization, discharges or clinical questions: email or call 1-800-424-4046.

Fraud and Abuse
1-800-755-0850
Special Investigations Unit Email: SIU@magellanhealth.com.

For quality of care concerns, general questions or comments, please call:
Toll-free: 1-800-424-4046