Get Easi Form - Magellan Provider ''s Home Page

Completing the EASI Form is a crucial step for providers wanting to ensure proper compensation for services delivered. This guide provides clear, step-by-step instructions to help users fill out the form accurately and efficiently.

Follow the steps to complete the EASI Form effectively.

1. Click the ‘Get Form’ button to access the EASI Form and open it in your preferred editor.
2. Begin by entering your unique identifier in the 'MIS#' field, which is essential for processing.
3. Provide the TIN/SSN in the next field to facilitate payment for your services.
4. Fill in the clinician’s name in the designated section, followed by the agency or organization name.
5. Complete the street address, state, city, and zip code of your practice.
6. Enter the case number or MAT number along with the client’s name and their SSN, ensuring all data is accurate.
7. Document the 'Time Seen' in minutes, specifying the start time of the appointment and the session date(s). Make sure the 'Time Seen' reflects any sessions that exceeded the standard duration.
8. List the attendees present during the session, indicating if they were an employee, spouse, dependent, or other.
9. Note whether this billing is for an interim or a final bill.
10. Indicate the race/ethnicity of the client by marking the appropriate circle.
11. Detail the assessed problem by selecting the relevant issues faced by the client.
12. Complete the statement of understanding section, confirming whether the member signed or refused to sign.
13. Fill in the client's level of functioning before and after the session.
14. Answer questions related to risk of harm and include any relevant screenings completed.
15. Ensure all sections are filled before signing and dating at the end of the form.
16. Once completed, save your changes, then explore options to download, print, or share the filled-out form for submission.

Start filling out the EASI Form online today to ensure timely processing of your billing needs.