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ALERT: Beware of false requests for medical records or PHI

Magellan recently learned that individuals posing as employees of other managed care organizations have sent false requests for information via email and texting to fraudulently obtain patient's medical records, PHI, or other sensitive information.

Such messages may look authentic and could include the name of the individual investigator or other staff member and job title, but typically they do not have an authentic company email address.

How to recognize legitimate requests from Magellan

  • Communications regarding the audit/investigation process will be communicated either by phone or email from an @MagellanHealth.com email account.
  • Correspondence from the Magellan SIU Department will always include the auditor or investigator's name, title, phone number and email address.
  • Magellan does not request medical records or other protected health information through instant messaging systems or through email conversations such as Google Chat.
  • Magellan does not require bank account or credit card information as part of the investigation process.

More information

For more information regarding SIU's audit and investigation processes, please review Magellan's policy in Section 4, of Magellan's National Provider Network Handbook (PDF), including the section on What to expect during a FWA or overpayment audit or investigation

Questions?

If you have received correspondence from Magellan Health SIU and need to verify if the communication is legitimate, contact our Special Investigations Unit (SIU) through our 24-hour Fraud Hotline at 1-800-755-0850 or by email at SIU@MagellanHealth.com.

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About Provider Focus

Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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