Magellan Health
Magellan Health is a payer organization. For an ASC, what matters isn't the logo. It's how Magellan Health pays: where it runs rich, where it runs thin, and how its reimbursement compares with peer plans for the same procedures.
Pilot Analysis
Get the complete Magellan Health analysis
Tell us where to send it. Our team will prepare an analysis of Magellan Health covering rates by code, market position, and underpaid areas, and email it to you within 5-10 business days. Need it faster? Book a demo.
What Insights reveals
How Magellan Health pays
See how Magellan Health reimburses across procedures and markets, benchmarked against the peer plans competing for the same cases. Not a raw rate sheet, a read on where it sits.
Geographic footprint
See where Magellan Health concentrates and how its presence shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for Magellan Health and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive Magellan Health's volume, so you know where a rate change moves the needle.
Whether you're an ASC benchmarking a contract or a provider team looking Magellan Health up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with Magellan Health
- Payer ID
- 01260 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to Magellan Health through a clearinghouse.
- Eligibility verification
- Coverage and benefits for Magellan Health members are verified before the date of service, through a clearinghouse using payer ID 01260or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with Magellan Health directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of Magellan Health the way it pays.
- What is Magellan Health's payer ID?
- Magellan Health's electronic payer ID is 01260. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to Magellan Health through a clearinghouse.
- How do ASCs verify eligibility for Magellan Health members?
- Eligibility and benefits for Magellan Health members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 01260) or through the payer's provider portal.
- Does Magellan Health require prior authorization for ASC procedures?
- Prior-authorization requirements for Magellan Health are set per plan and per procedure. Confirm whether an authorization is required with Magellan Health directly before the date of service.
- What type of payer is Magellan Health?
- Magellan Health is a payer organization.
- How does Magellan Health compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where Magellan Health pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is Magellan Health paying my ASC below market?
- Put your own Magellan Health contract next to the peer benchmark in DataLily AI and you'll see the gap by procedure and market, the fastest way to know whether you're leaving money on the table.