Submitting Electronic Transactions/Claims to Magellan
Electronic transactions, including claims submitted to Magellan, must be HIPAA compliant so that member confidentiality is maintained. This webpage provides tools and resources to assist you in preparing to send/receive electronic transactions.
Please evaluate and take advantage of one of the electronic methods available to you for submitting your claims quickly and easily. All of Magellan’s claims tools are designed to save you time and eliminate paperwork burden while supporting accurate, timely claims payment.
1. Clearinghouses
External electronic data interchange (EDI) clearinghouses act as a middleman between the provider and Magellan, and can transform non-HIPAA-compliant formats to compliant 837s. Magellan accepts 837 transactions from a number of clearinghouses. Note that there may be charges from the clearinghouses. Review the clearinghouse contact information.
2. Individual claim submission via Availity Essentials
Use Availity’s portal, Availity Essentials, to submit your Magellan claims. If you’re already using Availity Essentials with another payer, you’re set to work with Magellan on Availity Essentials. If you don’t already use Availity Essentials, set up your account now. There is no cost for registration or use. Availity has complimentary webinars and resources to help you get started with your registration.
3. Individual claim submission via MagellanProvider.com
Accessible via this Magellan provider website after secure sign in, our Submit a Claim Online application (Claims Courier) is a web-based data entry application for providers submitting professional claims on a claim-at-a-time basis. There is no charge to you for use.
4. Direct Submit
You can send HIPAA-compliant 837 files directly to Magellan in bulk, without accompanying claim data entry or the involvement of a clearinghouse. Direct Submit is available to all providers regardless of claims submission volume. There is no charge to you for using the service.
If you would like to perform testing for submitting EDI claims directly to Magellan, contact our EDI Support team at [email protected] or 1-800-450-7281, extension 70536 to get started.