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  • Magellan Complete Care Provider Complaint Form

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Manner . Thank you. Request for Authorization Requestor/Contact Information Requestor Name: Facility Name: Direct Contact Telephone Number: Member Information Fax information sent pertains to: Name (Last Name, First Name): Date of Birth: Medical Records Florida Medicaid Transition of Care Other Fax Number: Inpatient Outpatient BH PH Member Number / Medicaid ID: Diagnosis Code: CPT Codes: Please be sure to attach any clinicals NOTE: A Fax Processing Form MUST be submitted along with eac.

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Magellan Specialty Health is a specialty benefit management organization that offers utilization management solutions to health plans, including radiology management, musculoskeletal management, physical medicine management and genetic testing solutions.

Centene has completed its sale of Magellan Specialty Health to Evolent Health.

Magellan and QualityMetric, Incorporated (now part of Optum) worked together to create the SF-BHâ„¢ Assessment.

Magellan Healthcare, Inc. (Magellan) is a managed care behavioral health care company contracted by AmeriHealth to manage the mental health and substance abuse benefits for the majority of our Members with HMO, POS, PPO, EPO, and CMM coverage.

Within sixty (60) days of the claim settlement for third party claims. This date is based on the date of the other carrier's decision. If Magellan does not receive a claim within these timeframes, the claim will be denied.

Magellan manages some components of Kaiser Foundation Health Plan of Washington and Kaiser Foundation Health Plan of Washington Options, Inc. (Kaiser Permanente) HMO, POS, PPO, and Medicare provider networks for outpatient mental health and substance use disorders services.

Magellan Complete Care is a Florida Medicaid specialty health plan for individuals living with a serious mental illness.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232