Getting paid

Outpatient provider rates

Prior to the effective date of the IBHP program, this rate schedule is subject to change at the discretion of Magellan. Magellan will post all updates on this website and send communications to providers notifying them of any changes.

After the effective date of the IBHP program (July 1, 2024), changes will be made in accordance with the provisions of your provider agreement.

Magellan Idaho Behavioral Health Plan Rates for Outpatient Providers – effective July 1, 2024

Posted Feb. 26, 2024

Submitting claims

Magellan is committed to reimbursing our providers promptly and accurately in accordance with our contractual agreements.

We encourage providers to submit claims electronically using one of the following methods. (Effective July 1, 2024)

Option 1 – Individual claims

You can submit individual claims to Magellan Healthcare of Idaho using Availity Essentials.

• If you’re already using Availity Essentials with another payer, you’re set to work with Magellan on Availity Essentials.
• If you don’t already use Availity Essentials, set up your account now. (There is no cost for registration or use.) Availity has complimentary webinars and resources to help you get started with your registration. How to get started with Availity.

Option 2 – EDI claims

HIPAA-compliant 837 files can be sent directly to Magellan in bulk, without accompanying claim data entry or the involvement of a clearinghouse. Direct Connect is available to all providers regardless of claims submission volume. There is no charge to you for using the service. You can register to submit EDI claims to Magellan by sending an email to EDISupport@MagellanHealth.com.

Option 3 – Clearinghouses

External EDI clearinghouses act as a middleman between the provider and Magellan, and can transform non-HIPAA-compliant formats to compliant 837s. Magellan accepts 837 transactions from a number of clearinghouses.

Electronic Remittance Advice Form for clearinghouses (PDF)

NOTE: There may be charges from the clearinghouses.

We strongly encourage all providers to submit claims to Magellan electronically via one of the methods above; however, if you opt to file on paper, submit claims to: Magellan Healthcare, Inc. P.O. Box 1029 Maryland Heights, MO 63043.

Payment method

Coming soon