Credentialing Process

Magellan is committed to promoting quality care for its members. In support of this commitment, practitioners must meet a minimum set of credentialing criteria in order to be able to provide services to our members as in-network providers.

To be eligible for referrals, Magellan network providers must successfully complete the credentialing review process prior to being accepted as a network provider. We credential providers in accordance with our credentialing criteria and in accordance with specific criteria required by applicable regulatory agencies and/or client companies.

Magellan participates in the Council for Affordable Quality Healthcare (CAQH), which offers a Universal Credentialing DataSource to help providers reduce the amount of administration and paperwork involved in credentialing and re-credentialing. If you are unfamiliar with the process, be sure to view a short tutorial developed by CAQH.

For more information about credentialing, consult the Magellan National Provider Handbook, section 2, and for information on facility/organization credentialing, consult the Organizational Provider Handbook Supplement.