Welcome to Magellan's Claims Search application. This application can be used to view claims processed by Magellan Health, Inc..
Click Check Claims Status on the left-hand side menu on the MyPractice Page.
Check Claims Status tab:
EOB Search tab:
Field Name | Definition |
---|---|
Provider TIN | The Federal Taxpayer Identification Number of the provider or provider organization rendering services (found in Box 25 on the CMS 1500 or Box 5 of the UB-04). |
Member No. | The patient's member number assigned by Magellan. |
Subscriber No. | The member Number assigned by the health plan customer, or, if that number is unavailable, this is the member number assigned by Magellan. |
Claim Number | Number assigned to the claim by Magellan's claims processing system. |
Medical Record Number | Also referred to as the Patient Account Number. |
Institutional Bill Type | The Bill Type code (found on UB-04 paper form, locator 4). |
Total Paid Amount | Total paid for the claim. |
Entity Identifier | Some Claim Status Category codes contain the wording "entity" a part of the description. This code identifies the person(s) to whom that entity refers. Example: Entity Identifier QA indicate the entity is the patient. |
Total Billed Amount | Dollar amount billed for the service(s) (found in Block 28 on CMS 1500). |
Health Care Claim Status Category Code | The Health Care Claim Status Category codes indicating the general category of the status of a claim. |
Health Care Claim Status Code | The Health Care Claim Status codes indicating further detail about the reason a claim has a particular Health Care Claim Status Category Code. |
Status Date | The date the claim was placed in the status indicated in the Health Care Claim Status Category Code field. |
Adjudication Date | The date a claim was finalized, but has not yet been through an adjudication cycle. |
Adjudication Status | The status of the claim indicating further detail about the adjudication processing of the claim. |
Check Date | The date the check was issued. |
Line Number | Number assigned by Magellan's claims processing system to the specific line item on the claim. |
Beg. Date | First date of service (found in Block 24A on CMS 1500 or Box 6 on UB-04). |
End Date | Last date of service (found in Block 24A on CMS 1500 or Box 6 on UB-04). |
Units | Number indicating the quantity of the service (found in Block 24G on CMS 1500). |
Procedure Code | CPT, HCPCS or other code defining the service billed (found in Block 24D on CMS 1500 or Box 44 on UB-04). |
Modifier | Modifier that further defines the service billed (found in Block 24D on CMS 1500 or Box 44 on UB-04). |
Category Code | The Health Care Claim Status Category codes indicating the general category of the status of the claim line. |
Status Code | The Health Care Claim Status codes indicating further detail about the reason a claim has particular Health Care Claim Status Category Code. |
Entity ID | Some Claim Status Category codes contain the wording "entity" as part of the description. This code identifies the person(s) to whom that entity refers. Example: Entity Identifier QC indicates the entity is the patient. |
Status Date | The date the claim line was placed in the status indicated in the Health Care Claim Status Category Code field. |
Billed Amt | Dollar amount billed for the service (found in Block 24F on CMS 1500). |
Paid Amt | Dollar amount paid to the provider for the service. |
Allowed Amt | Dollar amount allowed/contracted for the service. |
Patient Paid | Dollar amount paid to the patient for the service. |
Copay/Coins/Ded Amt | Dollar amount of the member's copayment, coinsurance, and/or deductible deducted from the Allowed Amount. |
Other Ins Paid Amt | Dollar amount paid by other insurance carrier(s). |