Frequently Asked Questions: Online Professional Claims Submission
General FAQS
Q. Does Magellan have an online claims submission application on its website?
A. Yes, Magellan offers our providers a browser-based online claims submission application for professional services. Professional services include those services typically billed using a Form CMS-1500 or UB-04.
Q. What are the benefits of using the online claims submission application?
A. Electronic claim filing is more efficient and cost effective. You don't have to keep track of or file paper claims, and you receive confirmation of receipt within one day of filing the claim. And best of all, filing online claims using the browser-based application is free to providers that have secure access to the Magellan provider website.
Q. What type of claims may be submitted using the online claims submission application?
A. Claims for services normally submitted on a CMS-1500 or UB-04 may be submitted using the online claims submission application.
Q. Are there service payment requests that cannot be submitted using the online claims submission application?
A. Employee Assistance Program (EAP) reimbursement requests cannot be billed using the online claims submission application. Submit EAP reimbursement requests via the EASI Form.
Q. Is there a charge to submit claims through Magellan’s online claims submission application?
A. No, this service is offered free to Magellan providers who have secure access to the Magellan provider website.
Q. Is there something I have to load on my computer to use the online claims submission application?
A. No. Online claims submission is a browser-based application. You will only need to launch your Internet browser and log on to the Magellan provider website using your secure username and password.
Q. How can I access the online claims submission application?
A. You will need to sign in to the website with your username and password to access the claims submission application. If you are currently a credentialed and contracted Magellan provider and you do not know your username and password, click on the New User link (or the Forgot Password? or Forgot Username? links) in the Sign-In box on the Welcome Page. If you are a new user, you will be required to accept a user agreement and provide some information about yourself and your practice. If the system fails to recognize you and does not return a login and password, please contact us via secure message or call the Provider Services Line at 1-800-788-4005.
Q. Is the Online Professional Claim Submission application secure and HIPAA compliant?
A. Yes
Specific Application Questions
Q. Do I have to enter something in every field?
A. You may. It depends on the type of claim you are submitting. The application will guide you through the required fields and a Help document is available for each field within the application.
Q. Why is the PO Box number required?
A. The PO Box number that you would normally mail your paper claims to is required to make sure your claim is processed correctly. If your claim does not include the correct PO Box number, your claim may be rejected.
Q. What is an MIS number?
A. An MIS number is the provider identification number assigned to you by Magellan.
Q. Why do I have to enter my MIS number?
A. Your MIS number allows Magellan to process your claim efficiently. The MIS number makes sure the claim is paid to the appropriate provider and at the appropriate rates.
Q. How do I find out what my MIS number is?
A. Your MIS number may be printed on your authorization letters or on a Magellan EOP statement. If you are unable to locate your MIS number, call the Provider Services Line at 1-800-788-4005 to request it.
Q. How do I submit a claim that lists more than one visit?
A. You may enter up to a total of six lines per claim on the online claims submission application.
Q. What are POS codes?
A. POS stands for Place of Service. Enter the location where the service was rendered in this field.
Q. What if I make a mistake?
A. If you are working on the page where the mistake occurred, you can click on the field and correct your entry. If you have proceeded to the next page, you will need to click on the progress bar at the top of the page to access the page with the mistake. If you began entering new information on a page that is not yet saved, and decide to access information on a previous page, you will be prompted to save the current page prior to moving to another page.
To cancel the claim before submission, click on the “Clear Form” button, or close your web browser. Once the “Submit” button is clicked, the claim submission cannot be stopped or corrected.
Q. What if I don’t have time to complete the claim?
A. You may save an incomplete claim by using the “Save for Later” button on the bottom of the page. You will need to complete the current page in order to use this feature since partially completed pages may not be saved.
Q. What if I can’t find what I want on a drop-down menu?
A. If the information you require is not on the drop-down menu, the claim must either be submitted using an EDI transaction through one of our contracted clearinghouses, or be submitted on paper. Please review EDI information for more information about our clearinghouses.
Q. How will I know if my claim is accepted for processing?
A. You will be given the option of printing your completed claim prior to submitting it. In addition, within 24 hours of submission of a claim, you can check to see whether it has been accepted for processing or rejected by clicking on “View Submitted Claims” within the claims submission application. If your claim was rejected, a reason is provided to help you correct the claim for resubmission.
Q. My claims have been rejected for “invalid diagnosis.” What diagnosis should I use?
A. Magellan requires HIPAA compliant codes. The online claim submission application requires HIPAA compliant ICD-10 codes. Please refer to our Code Sets for more information.
Q. My claims have been rejected for “invalid CPT codes.” What CPT codes should I use?
A. Magellan requires HIPAA compliant codes on all claims submissions. The online claims submission application requires HIPAA compliant CPT codes. Please refer to HIPAA compliant codes for more information.
Q. If I have any questions, is there someone I can contact and get help?
A. Yes. If you are not able to get your question answered through our online Help, click on the FAQ link and send a message with your question.
Q. How can I make a suggestion to Magellan regarding the claim submission application?
A. We welcome your feedback. To submit your suggestions, please contact us.