Get Physical Health Prior Authorization Form - Magellan Complete Care
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How to fill out the Physical Health Prior Authorization Form - Magellan Complete Care online
Filling out the Physical Health Prior Authorization Form for Magellan Complete Care online can seem complex. This guide aims to simplify the process by providing clear, step-by-step instructions for each section of the form, ensuring that all users can complete it with confidence.
Follow the steps to effectively complete the prior authorization form online.
- Click the 'Get Form' button to obtain the form and open it in your preferred editor.
- Indicate the type of request being made by checking the appropriate box: Initial Request, Continued Care Request, or Continuity of Care Request.
- Input the date and time received by Magellan Complete Care in the designated field.
- Provide the enrollee's name and date of birth, ensuring that the information is accurate and complete.
- Fill in the member number, which is essential for identification within the Magellan Complete Care system.
- If applicable, list any other insurance coverage the enrollee may have in the provided space.
- Enter the requesting provider or facility's information, including name and contact telephone number.
- Provide the fax number for the referring provider or facility.
- Identify a contact person related to the request, ensuring that all details are clear.
- Specify the provider or facility being referred to, including the specialty and facility identification number.
- Indicate the urgency of the request by selecting either Routine or Urgent/Expedited.
- Complete the service request and place of service details, along with the diagnosis using the ICD-9 code.
- List the CPT codes along with the number of visits or units per code.
- Fill in the start date and end date for the requested service.
- Provide a detailed reason for the referral in the space provided, ensuring all relevant information is included.
- Attach any supporting documentation necessary to determine medical necessity.
- Once finished, fax the completed request to Magellan Complete Care at (888)-656-4894.
- If you have questions about services requiring prior authorization, contact customer services at (800) 327-8613.
- Save your changes, and if needed, download, print, or share the form for your records.
Complete your Physical Health Prior Authorization Form online today for a smooth submission process.
Magellan Complete Care (MCC) operates Medicaid health plans in Arizona, Florida and Virginia. Networks for these health plans are managed independently from our Magellan Healthcare behavioral health networks.
Fill Physical Health Prior Authorization Form - Magellan Complete Care
Magellan Complete Care of Florida has partnered with CoverMyMeds to offer electronic prior authorization (ePA) services. StepbyStep Guide to Completing Magellan Rx Prior Authorization Form. Step 1: Verify Patient Eligibility and Coverage. All providers are required to obtain prior authorizations for physical medicine services. Magellan also requires preauthorization for services to continue. Providers can ask for a review for more days before the last covered date for ongoing care. When you complete assessments, you share vital information that Magellan needs to provide essential care to youth and their caregiver(s). Authorization should be obtained prior to services being rendered and for continued services. Prior authorization—Review of clinical records ensures members receive medically necessary care for the proper length of time and frequency.
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