For Providers

Getting Paid

At Magellan of Arizona, we understand that getting your claims paid promptly and correctly is critical to the success of your practice. To assist you in submitting and tracking your claims, and receiving prompt and accurate payment, we provide a number of tools and resources.

By signing in to the Magellan Provider website with your secure username and password, you can submit a claim online and check claims status. Want to sign up for electronic funds transfers (EFT)?

Block providers should use the electronic funds transfer form provided above.

Fee for service (FFS) providers may sign up through the Magellan provider Web site.

Tools and resources

• Claims Presentation (1.2M)
• Provider Financial Reporting Guide (96K)
• Electronic Funds Transfer Form (for block providers only) (63K)
• Submit Intake Online

Electronic claims options for providers

Magellan of Arizona has developed a suite of electronic claims submittal offerings to best serve the needs of our Maricopa County providers for timely claims processing.

Direct submit

If you are able to submit electronic claims in a HIPAA-compliant 837 format, we recommend our EDI direct submit testing application. This application provides a secure method to send HIPAA transaction files directly to Magellan and is available at no cost to our providers submitting 160 or more claims per month. We offer two alternatives for claims submission: PGP encrypted files via FTP and files sent through the Web site.

Using this method for transmitting claims to Magellan allows you to:

• Use a secure method for transmitting claims
• Eliminate or avoid clearinghouse costs
• Submit multiple claims in batch mode
• Send files at any time - 24 hours a day, seven days a week

If you are unable to submit electronic claims in a HIPAA-compliant 837 format, we offer other options to meet your needs. Please note that providers still using the ValueOptions software to create electronic claims in an 837 format will not be able to use this tool to submit claims to Magellan.

For more information, please visit www.edi.magellanprovider.com.

Submit a claim online

Also known as Claims Courier, this Web-based data entry application is accessible 24 hours a day and allows users to efficiently submit professional claims on Magellan's Web site. Providers can manually enter claims data into Web screens in this user-friendly application. For more information, visit www.MagellanProvider.com and login to the secure provider site to utilize this application.

Clearinghouse submission

For submitters who are not able to use Magellan's no-cost options (Direct Submit or Claims Courier) and do not have the capability to create an 837, we recommend the use of a clearinghouse. Magellan is contracted with seven clearinghouses identified below.

Please note that Magellan has a special arrangement with NaviNet, a clearinghouse which provides setup and transactions at no cost to our providers.

Clearinghouse Contact Information

Payerpath (formerly Mysis and also known as Allscripts) 9030 Stony Point Pkwy Suite 440 Richmond, VA 23235 1-877-623-5706 www.payerpath.com

Capario (formerly MedAvant and ProxyMed) 1901 E Alton Ave, Suite 100 Santa Ana, CA 92705 1-800-586-6938 PayerAdvocacy@Capario.com

Availity (formerly THIN) PO Box 550857 Jacksonville, FL 32255-0857 1-800-282-4548 www.availity.com

Emdeon Business Services (formerly WebMD) One Century Place 26 Century Blvd, Suite 601 Nashville, TN 37214 1-877-469-3263 http://transact.emdeon.com/

Gateway EDI, Inc. One Financial Plaza 501 North Broadway 3rd Floor St. Louis, MO 63102 1-800-969-3666 www.gatewayedi.com

NaviNet Claims (also known as AmpMed Corporation) PO Box 31430 Santa Fe, NM 87594 1-866-398-7076 Fax: 505-988-7629 www.navinetclaims.com

RelayHealth (also known as McKesson) 700 Locust Street Suite 500 Dubuque, IA 52001 1-800-527-8133, Option 2 www.relayhealth.com

If you currently have arrangements with a clearinghouse that is not approved by Magellan, you can simply arrange for your clearinghouse to contact one of the approved clearinghouses to arrange for transmission of claims.

It is important to include:

• Magellan's Maricopa County P.O. Box 67090
• Your national provider identifier (NPI) number and taxpayer identification number (TIN)

If you have questions regarding electronic claims submission, please e-mail them to EDISupport@MagellanHealth.com for resolution.

EDI testing center for high-volume providers

Our EDI Direct Submit Testing application is an electronic claims tool available on www.edi.magellanprovider.com. This application is offered at no cost to our high-claims-volume providers and is limited to providers submitting at least 160 claims per month. This application can be used to send HIPAA transaction files directly to Magellan, allowing you to receive response files without the use of a clearinghouse. The HIPAA transaction files that Magellan currently supports include the 837P and 837I claims submission files. Files sent to Magellan will be validated, and if certification is granted, you will be permitted to submit claims files and receive responses.

Using this method for transmitting claims to Magellan allows you to:

• Use a secure method for transmitting claims
• Eliminate or avoid clearinghouse costs
• Submit multiple claims in batch mode
• Send files at any time - 24 hours a day, seven days a week

When you access the EDI Testing Center site, you will register for a new account, complete a survey and then submit test files using our EDI Testing Center. An IT analyst will be assigned to support you during the process. You will be required to submit a minimum of two test files that successfully process and return response files before Magellan will permit submission of files to production (i.e., live claims processing).

We offer two alternatives for claims submission: PGP encrypted files via FTP and files sent through the Web site.

If you have any questions about the process, contact us at EDISupport@MagellanHealth.com.

For additional information on Magellan claims, please visit Provider Claims Resources.

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