ComplaintsforMagellan Health Care
Need to file a complaint?
BBB is here to help. We'll guide you through the process.
Complaint Details
Note that complaint text that is displayed might not represent all complaints filed with BBB. See details.
Initial Complaint
04/17/2023
- Complaint Type:
- Customer Service Issues
- Status:
- Unanswered
I have been unable to view the *** explanation of benefits documents for months. I have contacted Magellan health numerous times and they say it's fixed. But it still does not work. Username blb9101Initial Complaint
02/02/2023
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
Magellan Health is NOT in parity with other commercial insurance payors in regards to behavioral health services in *** *****, **********. Specifically in regards to Partial Hospitalization, Intensive Outpatient and Outpatient services. I am an owner of 2 behavioral health organizations: 1) ***** **** ******** ********* - PHP/IOP adults/adolescents ********************) and 2) ** ******** ***** (*******************) - Outpatient psychiatry practice. My points of contact at Magellan are **** ***, ******** ******, ******** ********** (************************) regarding ***** ****. ****** ******** (*****************************) (unsure of title); however, I believe she works on Outpatient Psychiatry credentialing/contracting re ** ******** *****. My first correspondence with ****** occurred on 9/16/22 after the **** *** finally emailed her to reach out to me directly given Magellan's 'join the network' portal was NOT FUNCTIONING which I emailed jill about on 9/7, 9/8, 9/13 and 9/16 with screen shots of inoperable portal. ****** sent me the attached screen shot of rates Magellan reimburses for OP psychiatry on 10/5/22. Note CPT code 99205 which is more than 50% less than what other providers in our area are being reimbursed. Also attached in an EOB DEMONSTRATING the difference. I've followed up with ****** 11/1, 11/29, and 1/11/23 without resolution. This is despicable especially given the 'opioid/mental' health crisis and this Payor's refusal to communicate or be on parity with other payors. See attached screenshot with CPT codes from ***** ******. Quite the difference. Magellan health is a mental health service administrator (MHSA) on behalf of **** ****** of ********** which took ** ** *** just to even get them to authorize treatment on par with other payors. Magellan/**** ******** unwillingness to be on parity with other payors severely decreases PROVIDERS wanting to join the network thus limiting the opportunity for member to receive behavioral healthcare.Business response
02/03/2023
The complaint has been received by Magellan and will be processed. I will send updates once additional information has been received.Business response
02/09/2023
I am waiting for the final version of the Determination letter and would like to request a short extension to allow extra time to submit this resolution. Thank you for the help in this matter.Business response
02/10/2023
Here is the determination letter. This should resolve this matter. Please contact me if you have any questions.Initial Complaint
11/07/2022
- Complaint Type:
- Customer Service Issues
- Status:
- Answered
We are healthcare providers (physical and occupational therapists) who have been providing skilled care to a patient following a stroke. He needs continued therapy to continue to increase his independence and safety and he has made significant gains with therapy. The insurance company has authorized a few visits, and when we file to submit for more visits, our front office staff is spending hours of time on the phone getting no where. They continually transfer the front office staff and then will abruptly hang up. We have been waiting since August for authorization to continue physical therapy and have not been able to get any answers. This is unethical behavior and we would like to get answers for our patient.Business response
11/08/2022
We are unable to participate in your complaint resolution process due to the health information privacy restrictions and requirements of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), it’s implementing regulations, and applicable state privacy laws. I will further state that we do have a complaint policy and procedure in place wherein we respond directly to such individuals or associated health plans to address any problems or concerns, and we will follow that policy in this case.
Thank you.
***** ** ****** ***
Initial Complaint
01/10/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
***** **** ******** ********* (*******************) is a CONTRACTED provider of behavioral health services for Magellan Health (**** ****** of California's 3rd party benefits administrator) since 2019. Our former provider relations rep ***** ******* is no longer with the company and his replacement/boss **** Day has stepped in to fill his role. ****'s behavior has been unsettling to say the least. Sober Life currently has over 13 contracts with insurer's and both Magellan's patients length of stay AND reimbursement rates are FAR below industry standards. Additionally, **** will go weeks to months without responding to my emails and she is the ONLY one who can solve the issues we are having. She promised in writing to have her clinical executive team review pertinent clinical data to explain their SUBPAR lengths of stay. She has NOT done this! Also, she has promised to review our proposed rate increases (given inflation and opioid epidemic) which she has NOT done and now does not respond to emails or calls. This is horrible and I don't know what else to do. Attached is our email thread... pay attention to the dates and what she's promised, yet NOT delivered. Also, see the 2020 payor compare... SHOWING Magellans malfeasance.
*Some consumers may elect to not publish the details of their complaints, some complaints may not meet BBB's standards for publication, or BBB may display a portion of complaints when a high volume is received for a particular business. ↩
BBB Business Profiles may not be reproduced for sales or promotional purposes.
BBB Business Profiles are provided solely to assist you in exercising your own best judgment. BBB asks third parties who publish complaints, reviews and/or responses on this website to affirm that the information provided is accurate. However, BBB does not verify the accuracy of information provided by third parties, and does not guarantee the accuracy of any information in Business Profiles.
When considering complaint information, please take into account the company's size and volume of transactions, and understand that the nature of complaints and a firm's responses to them are often more important than the number of complaints.
BBB Business Profiles generally cover a three-year reporting period. BBB Business Profiles are subject to change at any time. If you choose to do business with this business, please let the business know that you contacted BBB for a BBB Business Profile.
As a matter of policy, BBB does not endorse any product, service or business. Businesses are under no obligation to seek BBB accreditation, and some businesses are not accredited because they have not sought BBB accreditation.
Customer Reviews are not used in the calculation of BBB Rating
Customer Complaints Summary
4 total complaints in the last 3 years.
0 complaints closed in the last 12 months.