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Issue Escalation and Resolution
Escalation of Issues:
Providers should seek resolution with Magellan of Louisiana, using the two tier process that has been developed for escalation and resolution. This process is in place for both in-network and out-of-network providers to dispute Magellan’s policies, procedures, or any aspect of Magellan’s administrative functions.
Magellan strongly recommends that providers document the name of the representative(s) with whom they speak or communicate along with the time and date and provide that information as issues are escalated. Note that if e-mailing protected health information to the Health Plan (or LDH), providers should use secure e-mail. Magellan is required to submit a monthly report of all provider complaints to LDH including the issue in the complaint. These reports are closely monitored by LDH for trends and matters that may require corrective action by Magellan.
Two Tier Process for Escalating Issues:
- Tier 1 Escalation – Network Management Specialist Level
Contact your Network Management Specialist by phone or email, or by calling the toll-free provider line at 1-800-424-4489.
- Tier 2 Escalation – Executive Leadership Level
Please select Gail Fowler, Network Development Administrator, from the drop down list and submit your complaint online.
Subscribe to our Provider Updates
Magellan often posts provider updates, news and announcements to address systemic or trending provider issues. If you would like to subscribe to our provider updates, please contact us via email.
Contact Louisiana Department of Health (LDH) Office of Behavioral Health (OBH)
If a provider is unable to reach satisfactory resolution or get a timely response through the Magellan escalation process, direct contact with LDH-OBH should be the final step.