When an authorization of care is required, our philosophy is to base authorization on a thorough assessment of the member’s unique needs to be delivered at the least-intrusive appropriate level, and to do so in a timely and efficient manner.
For most plans Magellan manages, routine outpatient visits do not require pre-authorization or concurrent review. You simply file your claim and respond to any outreach calls from a Magellan care advocate, should such occur. View a provider orientation to our outpatient model.
If you have any questions about coverage and whether pre-authorization is necessary for the service you are providing, contact us at the number on the member’s benefit card.