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About Magellan in Louisiana

Claims for Services Provided Prior to 12-1-2015

 

  • All authorized and covered services provided to LBHP members on or before November 30, 2015, will be payable by Magellan.
  • For those members in covered 24 hour behavioral health services at midnight on November 30, 2015, there will be days in December which will be authorized and paid by Magellan as indicated under Authorizing Services Prior to 12-1-15.
    • Non-ambulatory detox
    • Inpatient psychiatric
    • Substance use residential (ASAM Levels 3.1, 3.3, 3.5, 3.7 and 3.7D)
    • Psychiatric Residential Treatment and Therapeutic Group Home
  • One year timely filing applies to all covered Medicaid services provided to LBHP members. The provider has 365 days from the date of the service to submit the claim.
  • Claims Disputes (provider appeals) will be accepted by Magellan after November 30, 2015, for dates of service up to November 30, 2015.
    • Provider claims disputes will be accepted by Magellan through May 31, 2017.  Note that providers have 365 days from the date of service to submit claims and then 180 days from the date of the Explanation of Benefits (EOB) to dispute those claims. 

Electronic Claims for Services Provided Prior to December 1, 2015

Please take advantage of one of the electronic methods available for submitting your claims quickly and easily.

  • Providers using Clinical Advisor, powered by ClaimTrak*, which was decommissioned December 1, 2015, should submit claims via that system through February 29, 2016, for dates of service prior to December 1, 2015. 
  • Providers not using Clinical Advisor may sign in securely to Magellan's provider website. Options available:

Find out about Magellan's electronic submission process in the Getting Paid section of our provider website.

* Clinical Advisor will be decommissioned December 1, 2015.  Read more.

Paper Claims

Because it enhances our ability to pay you timely and accurately, we strongly encourage you to submit claims electronically. If you are not able to submit electronically, we will accept paper claims via a CMS-1500 form.

Paper claims must be submitted to:

Magellan Health Services
PO Box 2064
Maryland Heights, MO 63043

Organizational Providers -- License-Level Modifiers

Organizations should reference our license-level modifier sheet when submitting outpatient therapy services claims.

Do you have a claims dispute?

Claims Disputes(provider appeals) will be accepted by Magellan after November 30, 2015, for dates of service up to November 30, 2015.

  • Provider claims disputes will be accepted by Magellan through May 31, 2017.  Note that providers have 365 days from the date of service to submit claims and then 180 days from the date of the Explanation of Benefits (EOB) to dispute those claims. 
  • All provider appeals regarding claims for services provided prior to December 1, 2015, should be mailed to: 

    Magellan Health, Inc.
    Appeals and Grievances
    P.O. Box 84380
    Baton Rouge, LA 70884
    Or

    1-888-656-4977 (fax)

    Or

    LBHPAppeals@magellanhealth.com (email)

  • For questions regarding retrospective reviews, appeals, or claim disputes, please email us at LBHPAppeals@magellanhealth.com 

 

 

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