Network Notes
Compliance with Re-Credentialing Requests, Timelines Helps Ensure Uninterrupted Network Participation
Magellan Accepts CAQH Applications
Every three years, Magellan must verify our network providers’ credentials in order to maintain accreditation with the National Committee for Quality Assurance (NCQA) and other accrediting bodies, and to satisfy customer requirements.
“Magellan’s credentialing department is accredited by NCQA as a Credentialing Verification Organization (CVO). We also participate with the Council for Affordable Quality Healthcare (CAQH) to make credentialing and re-credentialing easier for providers,” according to Nadine Coy, Magellan’s director of professional credentialing.
If you have completed your CAQH application and your attestation is current, Magellan will access your application six months prior to your re-credentialing date and begin the verification process. Please make sure your CAQH application is complete and that you have attested to it.
“We encourage providers to participate with CAQH. Magellan and many managed care companies participate with CAQH, which streamlines the credentialing process for providers,” says Coy.
Not participating with CAQH?
If you are not participating with CAQH, Magellan will send you an important notice six months before you are due to be re-credentialed. Please begin your re-credentialing early to ensure your network status is not interrupted.
You have three options* to complete your re-credentialing application:
- Submit an application through CAQH
- Complete a re-credentialing application on the Magellan provider website
- Call Magellan to request a hard copy application.
If you don’t complete your re-credentialing application within the required timeframe, you will no longer be able to participate in the Magellan network. We will send notice of impending termination within 90 days of the date of planned termination. If Magellan has not received a completed application within 60 days of your credentialing anniversary date, we send official notice of network termination. Once network status has terminated for non-compliance with re-credentialing requirements, no appeal is available. So providers who wish to continue participation will need to re-apply and begin the initial credentialing process.
We value your participation in the Magellan networks and want your participation to continue. Please note these requirements so your network status is maintained.
*Some states require completion of a state-specific application in hard copy format.