Member Materials

Grievances & Appeals

What is a grievance?

This is when you tell us that you are not happy with the services you received.

What is an appeal?

An appeal is a formal request to Magellan.  It asks for a review of a decision about your behavioral health services.

Grievances

Let us know:

  • When you are having trouble getting the services you need
  • When you are having trouble getting an appointment
  • When you are not happy with the quality of care or service
  • When you believe a provider did not respect your rights
  • When you have been abused or mistreated by staff of a provider
  • When you believe Magellan did not handle a concern right

You can tell us by phone, online, or in writing

To tell us by phone, please call:

Magellan at 1-800-424-4489 or 
If you are deaf or hard of hearing, call 7-1-1 to use the Louisiana Relay Service or call TTY number at 1-800-846-5277 and our Member Services staff will help you. 

You can mail your grievance

Send your grievance to Magellan at:

Magellan Health Services
Attn:  Grievance
P.O. Box 83680
Baton Rouge, LA 70884-3680

You can file you grievance online

Click Here to Send an Online Member Grievance (Called 'Complaints' after you click the link.).  Your grievance will be sent to us securely, and we will let you know within 3 business days that we received your grievance.

See your Magellan member handbook for more information on Magellan's grievance procedure.  

Appeals

You have the right to ask for a review of the following:

  • Denial of a service you or your provider asked for
  • Decrease in a service
  • End or suspension of a service
  • Denial of payment for a service
  • Failure to provide services fast enough
  • Failure of Magellan to act within time limits to solve an appeal or grievance
  • Denial of a request for services outside of the provider network. This applies when you cannot get needed services within the network.

How do I file an appeal?

If you need help sending an appeal, call Magellan at 1-800-424-4489 or if you are deaf or hard-of-hearing, call 7-1-1 to use the Louisiana Relay Service, or call TTY number at 1-800-846-5277 and tell the person who answers the phone that you want to file an appeal.

Can I file a written appeal?

You can also file a written appeal using our Member Appeal Form.

Mail, email, or fax your request and any supporting papers to:

Magellan Health Services
Attn: Appeals & Grievances
P. O. Box 83680
Baton Rouge, LA 70884-3680

Email:  LACSoCAppeals@magellanhealth.com 

Fax:   Toll-free 1-888-656-4102

Within 3 days of your request, Magellan will let you know in writing that we got your appeal.

Where can I find more about appeals?

Your Coordinated System of Care (CSoC) Member Handbook (pages 16-19) can answer more questions about appeals like:

  • What is an expedited appeal?
  • What happens after I file an appeal?
  • How is my appeal resolved?
  • What if I am not happy with my appeal results?
  • How do I ask for a State Fair Hearing?
  • What is the process for my State Fair Hearing?
  • How is my State Fair Hearing resolved?
  • Will my services continue during the Appeal or State Fair Hearing?

* If you’re helping someone who does not speak English, call the number above.  We will make sure they get help in their own language for free.

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