Magellan’s philosophy is to maintain a diverse, quality network of providers to meet the needs of our clients and members. In addition, we believe that providers should advocate on behalf of members in obtaining care and treatment for behavioral health and substance abuse disorders.
Network providers will not be terminated from Magellan networks for any of the following reasons:
- Provider advocating on behalf of a member
- Provider filing a complaint against Magellan
- Provider appealing a decision of Magellan
- Provider requesting a review of or challenging a termination decision of Magellan.
Network providers may be terminated from Magellan networks for the following reasons, including, but not limited to:
- Failure to submit materials for re-credentialing within required timeframes
- Suspension, loss or other actions on licensure
- Quality of care concerns
- Failure to meet Magellan’s credentialing criteria
- Provider-initiated termination
- No current business need within the provider’s geographic area, subject to applicable state and federal law.
For more information on your and Magellan’s contract termination obligations, consult the Magellan National Provider Handbook, section 2, and your Magellan agreement.