Submitting Claims

Click here to download our Claims Submission Reference Guide to ensure you are ready to file claims on July 1, 2024. Also, consider attending an upcoming live training session.

Magellan is committed to reimbursing our providers promptly and accurately in accordance with our contractual agreements. We encourage providers to submit claims electronically using one of the following methods:

Option 1 (fastest): Use a Magellan-preferred clearinghouse

External EDI clearinghouses act as a middleman between the provider and Magellan, and can transform non-HIPAA-compliant formats to compliant 837s. The clearinghouses listed in our Claims Submission Reference Guide are preferred by Magellan because we already have trading partner agreements and integration with them. 

  • Magellan’s payer ID: 01260
  • Submit claims with claim office ID: PO Box 1029

NOTE: There may be charges from the clearinghouses.

Option 2 - Individual claim submission via Availity Essentials

You can submit individual claims to Magellan Healthcare of Idaho using Availity Essentials. There is no cost to register for or use Availity Essentials.

  • If you’re already using Availity Essentials with another payer, you’re set to work with Magellan on Availity Essentials.
  • If you don’t already use Availity Essentials, set up your account now. Availity has complimentary webinars and resources to help you get started with your registration. How to get started with Availity.
  • You must submit claims with payer ID 01260 and claim office ID PO Box 1029.

Option 3 - EDI claims

You can send HIPAA-compliant 837 files directly to Magellan in bulk, without accompanying claim data entry or the involvement of a clearinghouse. Direct Connect is available to all providers regardless of claims submission volume. There is no charge to you for using the service.

You can register to submit EDI claims to Magellan by sending an email to EDISupport@MagellanHealth.com. See our Claims Submission Reference Guide for more detail.

Option 4 - Other clearinghouses

You may already work with a clearinghouse that is not on Magellan's preferred list. Note that some clearinghouses do not have all the capabilities needed to work with Magellan. We strongly recommend you switch to a preferred clearinghouse to get paid as quickly as possible.

If you want to use a clearinghouse not on our preferred list, please verify that they can send claims/837 files to Magellan. 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.

 

Additional information

Refer to Section 5: Provider Reimbursement in the IBHP Provider Handbook Supplement for additional claims information, including timely filing submission timeframes.