Claims Today

Electronic Claim Submission Tips

TIP: Take advantage of the electronic submission options Magellan offers.

More than 54 percent of our claim volume is submitted electronically and increasing! (The percentage increased from 49.6 percent in January 2008 to 54.2 percent in April 2008.) If you are a provider submitting on paper and would like to now submit electronically, check out the electronic (EDI) options we offer.

Improved efficiency
- No paper claims; no envelopes; no stamps
- Prompt confirmation of receipt or incomplete claim

Faster reimbursement
Improved quality
- Up-front electronic review ensures higher percentage of clean claims
- No data entry from paper claims
- Secure process
- HIPAA compliant.

TIP: Verify that TIN, NPI, name and address on claim matches Magellan’s system

The Magellan claim system is configured to match the provider information submitted on EDI claims to the correct provider record in our system. This process allows your claims to process quickly and accurately.
In order to match an EDI claim to the correct provider record, the Taxpayer Identification Number (TIN), National Provider Identifier (NPI), name and address must match the information in Magellan’s claim system.
To help avoid issues, please do not abbreviate and be careful to use the correct letter/number (e.g., do not substitute the letter “O” for zero).
If the system cannot find a match, the claim may reject. If the system attaches to an incorrect record because incorrect or incomplete information was submitted, the claim may take additional time to process.
If you have any questions about how to submit your provider information on electronic claims, please contact us at 1-800-450-7281, extension 75890. We can verify your information to help prevent delays in claim processing.

TIP: An electronic claim must pass validation before it is considered “received.”

It is critical to regularly check for and reconcile rejected claims to avoid missing timely filing deadlines.
All electronic claims – regardless of the method of submission (clearinghouse, direct submit, Claims Courier) – must pass through a validation process in order to be considered a “received” claim. Claims that do not pass validation will be rejected without being processed.
It is important to allow several days for the claim validation process.
Timely filing is determined by the number of days between the “received” date and the date of service.
If you have any questions about how to submit your provider information on electronic claims, please contact us at 1-800-450-7281, extension 75890. We can verify your information to help prevent delays in claim processing.