Magellan Health billing and credentialing
Billing and credentialing for behavioral health benefits managed by Magellan.
Working with Magellan Health
Magellan Health manages behavioral health benefits for health plans, employers and government programs, so a patient’s insurance card may show one company while Magellan processes behavioral health claims.
Plan types we bill:
- Behavioral health for health plans
- Employee assistance programs
- Government behavioral health programs
Credentialing and enrollment
Credentialing uses your CAQH ProView profile, which must be complete and re-attested every 120 days.
Prepare
Licenses, NPI, CAQH and group details checked and updated.
Apply
Application submitted for each provider and location.
Follow up
Status checked every 1 to 2 weeks until approval.
Confirm
Effective date and participation confirmed before billing.
Claims, eligibility and portals
Behavioral health claims go to Magellan when it manages the benefit, with Magellan’s authorization rules for higher levels of care.
Denials we prevent with Magellan Health
- Provider not credentialed or not linked to the group
- Out-of-area members not billed through BlueCard
- Missing prior authorization
- Coding and bundling edits under plan policy
- Late filing under the contract
Questions about Magellan Health
How do we know Magellan manages a patient’s behavioral health benefit?
The ID card or eligibility response usually lists a separate behavioral health phone number or payer. We check during verification.
Trademarks belong to their owners. MedAi Billing Solutions is an independent billing company, not affiliated with any payer or government agency.
Get help with Magellan Health claims
Send a few details and we will set up a short call to review your claims, denials and A/R. No cost and no commitment.
We sign a Business Associate Agreement before we handle any patient data.