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Change to Magellan Complete Care's observation services policy

As of July 19, 2018, Magellan Complete Care no longer requires an authorization for claims to pay for observation services (Rev Code 0762).

Magellan Complete Care will reimburse up to 48 hours of observation services without a subsequent inpatient admission*. A notification with clinical information is required for a subsequent inpatient admission for medical necessity review.

Please fax the inpatient notification and clinical information to the Utilization Management department at (888) 656-4894 within 24 hours of the inpatient admission.

 

*Please note: This change applies only to facilities contracted for observation level of care. 

 

If you have any questions please call us at 1-800-327-8613.

 

Posted on 7/24/2018