Magellan Healthcare
Provider Focus Newsletter
News & information for Magellan network providers


Help ensure your corrected claims get paid

Include appropriate qualifier and original claim number

Magellan continually assesses better solutions in applying consistent reimbursement using industry-standard guidelines.

Remember to include the appropriate qualifier and original claim number on corrected claims (CMS 1500 and UB-4):

  • 7Replacement of prior claim
  • 8Void/cancel of prior claim
  • Original claim number

Failure to include these elements on corrected claims will result in rejection or denial.

The corrected claim will be denied under code 3Y for the following reasons:

  • The appropriate qualifier was not submitted.
  • The original claim number was not submitted.
  • The claim number is valid but is NOT the original Magellan claim number, e.g. the number of a previous resubmission or another insurance carrier.

Thank you for your focus on helping members achieve their goals and work toward better lives! We all know that administrative tasks can be a hassle; however, taking just an extra moment to ensure the accuracy of your claims submission will help reduce errors and expedite payment.

As always, Magellan remains fully committed to reimbursing you accurately and promptly.

You can find policies relating to claims in the Magellan provider handbook (PDF), Provider Reimbursement section.

Be sure to review CMS’ NCCI webpage regularly to keep up-to-date on the specific edits that may affect your practice and payment for care to Magellan members.

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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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