Paper Claim Forms
We encourage providers to submit electronic claims, which allows for earlier detection of errors, drastically reducing the likelihood of claims being rejected or denied for payment, and often results in faster processing.
For non-facility-based professional services
For more information about the CMS-1500 form, visit the National Uniform Claim Committee’s website. Note that Magellan can only accept the current version of the CMS-1500 form.
For facility-based professional services
For more information about the UB-04 form, visit the National Uniform Billing Committee’s website. Contact your claim forms vendor to obtain full-color versions of the UB-04.
Magellan’s EASI Form
For EAP reimbursement
To receive payment for Employee Assistance Program (EAP) services rendered, you must complete and submit the Employee Assistance Service Information (EASI) Form.