MagnaCare
MagnaCare is a payer organization operating in New Jersey and New York. For an ASC, what matters isn't the logo. It's how MagnaCare 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 MagnaCare analysis
Tell us where to send it. Our team will prepare an analysis of MagnaCare 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 MagnaCare pays
See how MagnaCare 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
MagnaCare's presence spans New Jersey and New York. See where it concentrates and how that shapes the markets you compete in.
Peer position
Put your own position next to the benchmark for MagnaCare and bring the gap to your next contract conversation.
Specialty mix
Understand which procedures and specialties drive MagnaCare'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 MagnaCare up, DataLily AI maps how it reimburses across procedures and markets, and where your own rates sit against the peer benchmark.
Reference
Working with MagnaCare
- Payer ID
- 11303 is the EDI identifier used to route electronic eligibility checks (270/271), claim-status inquiries (276/277), and claims to MagnaCare through a clearinghouse.
- Eligibility verification
- Coverage and benefits for MagnaCare members are verified before the date of service, through a clearinghouse using payer ID 11303or through the payer's provider portal.
- Prior authorization
- Requirements are set per plan and per procedure. Confirm whether an authorization is required with MagnaCare directly before the date of service.
Book a demo: pick a time
A 15-minute walkthrough of MagnaCare the way it pays.
- What is MagnaCare's payer ID?
- MagnaCare's electronic payer ID is 11303. ASC billing teams use it to route eligibility checks (270/271), claim-status inquiries (276/277), and electronic claims to MagnaCare through a clearinghouse.
- How do ASCs verify eligibility for MagnaCare members?
- Eligibility and benefits for MagnaCare members are verified before the date of service, either electronically through a clearinghouse (a 270/271 transaction using payer ID 11303) or through the payer's provider portal.
- Does MagnaCare require prior authorization for ASC procedures?
- Prior-authorization requirements for MagnaCare are set per plan and per procedure. Confirm whether an authorization is required with MagnaCare directly before the date of service.
- What type of payer is MagnaCare?
- MagnaCare is a payer organization operating in New Jersey and New York.
- How does MagnaCare compare with other payers for ASC procedures?
- Ask Rose and you get a plain-language read on where MagnaCare pays above or below peer plans for your top procedures, charted, and ending in a recommendation you can take into a contract conversation.
- Is MagnaCare paying my ASC below market?
- Put your own MagnaCare 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.