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  • Pa Magellan Behavioral Health Initial Referral For Family-based Services 2022

Get Pa Magellan Behavioral Health Initial Referral For Family-based Services 2022-2025

Tion must be attached. Complete all four pages and fax to 866-667-7744. Date of Referral: Referring Agency Name: Referring Agency Staff Name: Referring Agency Phone #: Referring Agency MIS #: Referring Agency Staff Email: Referring Agency Fax #: Prescribing Doctor s Name: Prescribing Doctor s Email: Prescribing Doctor s Phone #: Member Special Needs/Accommodations: (if Applicable) Member Name: Preferred Name: DOB: School Name: MA ID # (10 Digits): Gender/Pronouns: Age: Race/Et.

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A. Under Magellan's policies and procedures, the standard timely filing limit is 60 days.

Under Magellan's policies and procedures, the standard timely filing limit is 60 days. For exceptions to timely filing requirements for specific states and plans, sign in to this website to view our timely filing exceptions. After signing in to your account, from Getting Paid, choose Preparing Claims.

Timely filing is when an insurance company put a time limit on claim submission. For example, if a insurance company has a 90-day timely filing limit that means you need to submit a claim within 90 days of the date of service.

Send to Magellan Health, Attn: Claims Dept. (VA DMAS) P.O. Box 1099, Maryland Heights, MO 63043. Please note: Only claims that were originally paid and have changes should be sent as corrected.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
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