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

region/plan-specific news : District of Columbia Medicaid

Expanding your business in 2022? That's great!

Make sure you let Magellan know about new locations and changes to your rosters.

Each location and all practitioners associated with the location must be in-network with Magellan to serve DC Medicaid enrollees in MedStar Family Choice Health Plan.

Group practices

Note: Each group practice location (including federally qualified health centers [FQHC] and care service agencies [CSA]) and associated practitioners must have unique Medicaid ID numbers.

Adding a new service location:

  1. After signing in at MagellanProvider.com, from the My Practice menu on the left, click Display/Edit Practice Information. The first tab is the Provider Data Change Form.
  2. Select Service Address, Hours & Medicaid ID Information to make changes to your service locations.

Adding new practitioners to your group roster (make sure to update for all locations):

  1. After signing in at MagellanProvider.com, from the My Practice menu on the left, click Display/Edit Practice Information. The first tab is the Provider Data Change Form.
  2. Select Roster Maintenance to make changes. Note: Adding a practitioner to the group roster does not automatically affiliate them to the group contract.
    • If the new practitioner is not already Magellan-credentialed, have them begin the credentialling process; this must be completed before the they are eligible to receive referrals.
    • To become credentialed, the practitioner should log on to CAQH at https://proview.caqh.org and complete their application, sending all required documents to CAQH. The practitioner must also attest to their information and authorize Magellan to access their application.
    • Remember: practitioners affiliated with a group practice must complete the individual credentialing process to render covered services to Magellan members.

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Each location and all practitioners associated with the location must be in-network
with Magellan to serve DC Medicaid enrollees in MedStar Family Choice Health Plan.

Facilities/organizations

Note: Each facility/organization location must have a unique Medicaid ID number. Practitioners associated with the organization do not need a Medicaid ID.

Adding a new service location:

  1. Email Kerri Kerr, contracts manager at KerrK@MagellanHealth.com.
  2. In your email, include the business name, billing NPI, TIN, primary location, and phone number.

Adding practitioners to your facility roster (make sure to update for all locations):

  1. For existing locations, after signing in at MagellanProvider.com, from the My Practice menu on the left, click Display/Edit Practice Information. The first tab is the Provider Data Change Form. For new locations, Magellan will request the facility staff roster upon initial setup.
  2. Select Roster Maintenance to make changes.

In support of efforts around diversity, equity and inclusion, Magellan now gives providers additional options for sharing gender with enrollees in our Provider Search. Learn more in our feature article.

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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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