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Magellan Referral Supplement
Please fax this completed form, along with the Behavioral Health Provider Data Form, to Capital Blue Cross at 717.526.3037. This information may be used in the referral
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How to fill out magellan referral supplement
How to fill out magellan referral supplement
01
Start by opening the Magellan Referral Supplement form.
02
Fill in the patient's information section, including their name, date of birth, and contact information.
03
Provide details about the referring provider, including their name, NPI number, and contact information.
04
Indicate the reason for the referral by selecting the appropriate option or providing a brief explanation.
05
Specify any special instructions or notes related to the referral, if necessary.
06
Sign and date the form to verify the information provided.
07
Submit the completed Magellan Referral Supplement form through the preferred method specified by Magellan.
Who needs magellan referral supplement?
01
Magellan referral supplement is needed by individuals who have been referred to a healthcare provider that requires additional information or documentation.
02
This may include individuals seeking specialized services, mental health treatment, or substance abuse programs.
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What is magellan referral supplement?
Magellan referral supplement is a form used to report referrals for services provided to patients by Magellan Healthcare.
Who is required to file magellan referral supplement?
Healthcare providers who have referred patients to Magellan Healthcare for services are required to file the referral supplement.
How to fill out magellan referral supplement?
Magellan referral supplement can be filled out online through the Magellan Healthcare portal or submitted through fax or mail.
What is the purpose of magellan referral supplement?
The purpose of magellan referral supplement is to track and report referrals made to Magellan Healthcare for services.
What information must be reported on magellan referral supplement?
Information such as patient demographics, services referred, date of referral, and referring provider details must be reported on the magellan referral supplement.
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