Claims Submission on Claims
Courier
Types of claims
accepted
Services normally billed on a professional claim
form, CMS-1500, may be submitted using the online
claims submission application, Claims Courier.
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Types of claims not accepted
Institutional claims normally submitted on a form
UB-04 and EAP claims may not be billed using
the online claims submission application, Claims
Courier.
EAP claims require a Case Closing Form and organizational
claims require additional information. Email
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UB-04
You may not submit UB-04 claims at this time. Organizational
claims require additional information that is not
required on a professional claim. However, we are
in the process of developing an online claim submission
tool for institutional claims. Watch for future
issues of Provider Focus for more on this upcoming
online tool.
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Non-participating providers
Only participating providers can
obtain a secure log in to access the online claims
submission application Claims Courier. If you are
a non-participating provider, and would like to become
a participating provider, please contact the Network
Representative in your state for information
and to request an application.
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Questions
There are help documents available in the online
Claims Courier application that will provide information
on what is required in each field. The information
necessary for the form is very similar to the CMS-1500 and the help text references the Block on
the CMS-1500 to assist you.
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Claims acceptance
You will receive a response report online within
24 hours that will tell you if your claim was accepted
for processing or was rejected. If it was rejected,
a reason will be provided on why the claim was
rejected to assist you in correcting the claim
for re-submission.
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Correcting mistakes
If you make a mistake and want to correct it while
you are still on the page where the mistake occurred,
you can simply click on the field and correct it.
If you have proceeded to the next page, you will
need to click on the "Back" button at
the bottom of the page to get to the
area you need to correct.
It's important to distinguish between the "Back" button
at the bottom of the page and the "Back" button
on your Web browser. If you use the "Back" button
on your Web browser, you will have to re-enter all
information on the previous page and the page you
were just on.
If you decide not to complete the claim, you will
need to click on the "Back" arrow button
on your Web browser or close your Web browser.
Once you click on the "Submit" button,
you are unable to stop the submission or correct
the information on the claim.
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Extra information required
A claim submitted through the online claims submission
application, Claims Courier is subject to HIPAA
requirements. The few extra fields in the claims
submission tool are there because they are required
by HIPAA for electronic claim filing.
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Do I have to enter something
in every field?
You may, depending on the type of claim you are submitting.
The fields required to complete the claim submission
are indicated with an asterisk.
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Why is the PO Box number
required?
The PO box number is necessary so that your claim
is processed correctly. It is the same PO Box number
to which you normally mail your paper claims. Without
the correct PO Box number, the claim may be rejected.
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I need an address where
we can send a claim for mental health services.
To determine the exact address for submitting a claim
for a specific benefit plan, please consult your
authorization of care letter, or call the member
services number on the member's benefit card.
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What is an MIS number
(MIS#)? Why do I have to enter
it? How can I find out what it is?
The MIS number is the provider identifier
assigned to you by Magellan.
Your MIS number allows Magellan to process your
claim efficiently and makes sure that the claim is
paid to the appropriate provider and at the appropriate
rates.
You may find your MIS number on many materials mailed
from Magellan. Your MIS number is printed on any
contracting or credentialing material that you have
received that includes a bar code at the bottom of
the document. Your MIS number is the first nine digits
after the barcode. (Usually ending in "000").
Some contracting or credentialing documents refer
to the MIS number as the "MHS Control No."
You can also call our Provider Services Line at
(800) 788-4005, and a representative will be able
to give you your MIS number.
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What if I can't find
what I want on a drop-down menu?
If the information you require is not in the drop-down
menu and you want to continue submitting an electronic
claim, you will need to send an EDI transaction through
one of our contracted clearinghouses. To obtain more
information, please review Submitting eTransaction information.
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How do I submit a claim
with more than one visit?
Just like on a paper CMS-1500, multiple lines can
be entered on a single electronic claim as long as
you are referencing the same member/patient and provider.
You may enter a total of six visits per claim on
the online claims submission Claims Courier tool.
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What are the POS codes?
POS stands for Place of Service. This tells us where
the service was rendered (i.e. inpatient hospital,
doctor's office, ER, etc.)
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My claims have been rejected
for "invalid diagnosis." What diagnosis
should I use?
Magellan recognizes HIPAA compliant codes. In this
case you must use ICD-9 codes. We have information
on HIPAA Code Sets.
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This application doesn't
offer the features of similar tools I use. Do you
have plans for enhancements?
Yes. In our ongoing commitment to
enhance our service delivery to you, we will constantly
monitor our systems and processes to make working
with Magellan easier. We will continue to enhance
and add more features to our site. We're always
interested in your feedback, so if you have particular
ideas or requests, please send
us your suggestions.
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Why should I use Claims
Courier?
Filing your claims electronically is much more efficient.
You no longer have to keep track of or file paper
claims, and you receive confirmation of receipt of
your claim within one day of filing.
Still can't find what
you're looking for?
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