Magellan Health provider portal, phone and payer ID quick facts
| Provider resource entry point | https://www.magellanprovider.com |
|---|---|
| Payer contact reference | 1-800-788-4005Provider website/login assistance and EDI Direct Submit onboarding. Member-plan benefit and claims contacts may differ; this is not a universal plan-specific claim-support line. |
| Claims payer ID | Magellan’s contracted-clearinghouse instructions identify 01260 for 837P and 837I claims. Confirm the member plan and clearinghouse arrangement; these claims instructions do not establish pharmacy, eligibility or ERA routing. |
| Eligibility payer ID | Stored eligibility references remain unverified for the current product and transaction. A claims identifier does not establish 270/271 routing. |
| ERA payer ID | 01260 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the applicable product, clearinghouse and enrollment. This claims comparison does not establish a universal 835 identifier. |
| Timely filing | Standard 60-day reference; state and plan exceptions apply |
| Prior auth route | Verify the current product policy and delegated reviewer; X12 278 support is not established by a portal link |
| Last reviewed | 2026-04-23 |
- Provider website/login assistance and EDI Direct Submit onboarding. Member-plan benefit and claims contacts may differ; this is not a universal plan-specific claim-support line.
- The official claim procedure describes a standard 60-day filing reference with state and plan exceptions. Confirm the governing provider agreement, member plan, start event and submission type before using the reference; this comparison does not approve one universal Magellan deadline.
- This registry has not established a payer-specific appeal ladder for Magellan Health. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
- Stored ERA references remain unverified for the applicable product, clearinghouse and enrollment. This claims comparison does not establish a universal 835 identifier.
Magellan Health at a glance
| Legal name | Magellan Health, Inc. |
|---|---|
| Also known as | Magellan Behavioral Health, Magellan Rx |
| Category | Third-party administrator (TPA) |
| Parent organization | Centene Corporation |
| Claims payer ID | Magellan’s contracted-clearinghouse instructions identify 01260 for 837P and 837I claims. Confirm the member plan and clearinghouse arrangement; these claims instructions do not establish pharmacy, eligibility or ERA routing. |
| Eligibility (270/271) payer ID | Stored eligibility references remain unverified for the current product and transaction. A claims identifier does not establish 270/271 routing. |
| ERA (835) payer ID | 01260 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the applicable product, clearinghouse and enrollment. This claims comparison does not establish a universal 835 identifier. |
| NAIC company code | Not established in this registry |
| States covered | Nationwide (50 states) |
| Members covered | ~40 million members |
| Provider resource entry point | https://www.magellanprovider.com |
| Provider phone | 1-800-788-4005Provider website/login assistance and EDI Direct Submit onboarding. Member-plan benefit and claims contacts may differ; this is not a universal plan-specific claim-support line. |
Always verify claims-routing details against the member ID card and the payer's current EDI companion guide before submission.
Timely filing & appeals for Magellan Health
The official claim procedure describes a standard 60-day filing reference with state and plan exceptions. Confirm the governing provider agreement, member plan, start event and submission type before using the reference; this comparison does not approve one universal Magellan deadline.
| Submission type | Window |
|---|---|
| Initial claim reference | Standard 60-day reference; state and plan exceptions apply |
| Out-of-network initial claim | Verify the member's plan and applicable out-of-network rules |
| Secondary / coordination of benefits | Verify the allowed window and start event; a primary EOB does not automatically restart filing |
| Corrected claim | Verify correction instructions; do not substitute an appeal deadline |
| Reconsideration / appeal | Use the applicable denial or decision notice and the process below |
This registry has not established a payer-specific appeal ladder for Magellan Health. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
Source: Magellan Health provider policy. Always confirm before disputing a TFL denial — payer policies are versioned and product-specific.
Prior authorization with Magellan Health
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
CMS-0057-F decision-timeframe requirements and exclusions
Verify Magellan Health electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable. Authorization requirements and submission channels depend on the product, service and delegated reviewer. Verify the applicable policy before scheduling; a portal listing is not proof of X12 278 connectivity.
This registry does not provide a current prior-authorization code list for Magellan Health. Start with the provider resources or the policy documents below, then confirm the applicable product, service and effective date. A resource link does not establish that a live code-lookup tool is available.
Top denial reasons for Magellan Health
Per-payer denial benchmarks publish here once the QuickIntell anonymized ETL pipeline ingests sufficient Magellan Health volume. Until then, see the broader CARC reference for industry-wide remediation guides.
Electronic claims, eligibility & ERA
| Transaction | Registry indication — not verification | Routing reference |
|---|---|---|
| 837P / 837I claims | Listed in registry; verify current scope | Magellan’s contracted-clearinghouse instructions identify 01260 for 837P and 837I claims. Confirm the member plan and clearinghouse arrangement; these claims instructions do not establish pharmacy, eligibility or ERA routing. |
| 270 / 271 eligibility | Listed in registry; verify current scope | Stored eligibility references remain unverified for the current product and transaction. A claims identifier does not establish 270/271 routing. |
| 278 prior authorization | Listed in registry; verify current scope | Verify X12 278 routing separately |
| 835 ERA | Verify support and enrollment separately | 01260 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the applicable product, clearinghouse and enrollment. This claims comparison does not establish a universal 835 identifier. |
Payer IDs vary by clearinghouse — confirm against your clearinghouse payer list (Availity, Change Healthcare/Optum, Waystar) before configuring submitter routing.
Source checks and remaining limits
The latest partial comparison is dated . Retained earlier findings keep their original dates below. This is a partial source check, not a whole-page, clinical or legal review. It does not refresh the legacy review date above.
portal_url
Source comparison: 2026-09-26
The provider site offers secure claims, eligibility and authorization tools plus plan-specific resources.
Primary source for portal_urlelectronic_claims_supported
Source comparison: 2026-09-26
Official instructions explicitly accept HIPAA 837 clearinghouse transactions and direct bulk submission, with additional single-claim portal options.
Primary source for electronic_claims_supportedpayer_ids.claims
Source comparison: 2026-09-26
The official clearinghouse page states 01260 for both 837P and 837I claims. This claim-routing evidence does not establish other transaction identifiers or pharmacy routing.
Primary source for payer_ids.claimsprovider_phone
Source comparison: 2026-09-26
Baseline 1-800-788-4005 is established for website/login help and Direct Submit onboarding. Preserve that role rather than imply a single plan-specific claim-benefit line.
Primary source for provider_phonetimely_filing_days
Source comparison: 2026-09-26
The official claim procedure states a standard 60-day limit with state/plan exceptions. Preserve 60 only as a qualified reference, with explicit exception and contract verification.
Primary source for timely_filing_days
Not checked in this pass: Whole-record approval, legal identity, ownership and complete product coverage; Authenticated transactions and QuickIntell integrations; payer_ids.eligibility/payer_ids.era/era_payer_id/supports_279_271/supports_278: The accessed ID table covers 837 claims only. It does not validate copying 01260 to eligibility or ERA, or X12 eligibility/authorization transport; portal functions are insufficient..
Sources used for this guide
Evaluate QuickIntell workflow fit for Magellan Health
These module references are evaluation starting points, not evidence of a validated connection, supported transaction or customer deployment. Confirm the actual member plan, data access and product scope first.
- QuickRCM
Evaluate claim preparation, follow-up and denial worklists for Magellan Health; verify the actual plan rules and available connections before implementation.
- QuickAuth
Assess authorization-packet and status workflows for Magellan Health; confirm product, service, delegated reviewer and permitted submission channels.
- QuickERA
Verify the actual 835 files, posting exceptions and reconciliation requirements for Magellan Health before evaluating automation. An ERA identifier alone does not establish supported ingestion or posting.
Frequently asked questions about Magellan Health
Where is the Magellan Health provider portal?
Use https://www.magellanprovider.com as a starting point for Magellan Health provider resources. This link may open a directory or contact page rather than a transaction portal. Select the applicable product and administrator, then verify the available functions, enrollment and access requirements. QuickIntell is not the official payer portal.
What is the timely filing limit for Magellan Health?
The official claim procedure describes a standard 60-day filing reference with state and plan exceptions. Confirm the governing provider agreement, member plan, start event and submission type before using the reference; this comparison does not approve one universal Magellan deadline.
Does Magellan Health publish a single claims payer ID?
This registry has not established one all-product claims payer ID for Magellan Health. Claims: Magellan’s contracted-clearinghouse instructions identify 01260 for 837P and 837I claims. Confirm the member plan and clearinghouse arrangement; these claims instructions do not establish pharmacy, eligibility or ERA routing.. Eligibility (270/271): Stored eligibility references remain unverified for the current product and transaction. A claims identifier does not establish 270/271 routing.. ERA (835): 01260 — registry reference; verify the member product, transaction and clearinghouse. Not verified: Stored ERA references remain unverified for the applicable product, clearinghouse and enrollment. This claims comparison does not establish a universal 835 identifier.. Do not substitute a claims ID for an unverified transaction ID. Look up the correct ID for the member's plan and transaction in your clearinghouse directory and verify against the member ID card before submission.
Does Magellan Health accept electronic claims?
Verify Magellan Health electronic claims (837), eligibility (270/271), remittance (835) and authorization (278) separately for the member product and clearinghouse. Registry flags and routing references are not current transaction-complete approval. Confirm the companion guide, enrollment and applicable source findings below. A blank or unverified field does not establish that the transaction is unavailable.
How do I appeal a Magellan Health denial?
This registry has not established a payer-specific appeal ladder for Magellan Health. Use the denial notice, plan document, provider agreement, or jurisdictional rule to assign the correct route and deadline. Missing registry evidence does not mean appeal rights are unavailable.
How long do Magellan Health prior authorization approvals take?
Decision deadlines depend on the product, service and urgency. CMS-0057-F generally starts its decision-timeframe requirements in 2026 for Medicare Advantage, Medicaid and CHIP payers subject to the rule: seven calendar days for standard requests and 72 hours for expedited requests. Those requirements exclude drug authorizations and QHP issuers on the federally facilitated exchanges. Other plans, state rules and permitted extensions can differ. Check the applicable policy; a decision deadline is not a guarantee of approval.
What is the Magellan Health provider phone number?
This registry lists 1-800-788-4005 as a contact reference for Magellan Health. Provider website/login assistance and EDI Direct Submit onboarding. Member-plan benefit and claims contacts may differ; this is not a universal plan-specific claim-support line.
Automate workflows around Magellan Health requirements
Connect eligibility, prior authorization, pre-submission claim checks, and remittance routing in one governed workflow. Payer and plan configuration is confirmed during implementation.
Disclaimer
This page is operational reference for medical-billing professionals. It is not legal, clinical, or contractual advice. Payer policies change without notice — always verify against Magellan Health's current published documents before submission. CPT® is a registered trademark of the American Medical Association.