Join our network
As a managed care leader, we value our network providers and realize that your time is best spent with members – not with an excess of administrative tasks.
What are the benefits of being a Magellan Complete Care of Virginia network provider?
We offer solutions to save you time and resources:
- Easy claim submission.
- Prompt payment and simplified credentialing.
- Access to free online provider education resources.
- Access to Provider Support Specialists - licensed nurses and behavioral health clinicians who offer training and technical assistance to providers to promote best practices and improve quality of care.
- Access to a dedicated after-hours Provider Concierge Line.
What does an individual provider/group practice/organization need to do to be considered an in-network provider with Magellan Complete Care of Virginia?
To be an in-network provider, the individual provider/group practice/organization must be contracted with MCC of VA. Prior to contract execution, we ensure practitioners and organizations meet credentialing criteria and are approved by Magellan Complete Care of Virginia's RNCC (Regional Network and Credentialing Committee).
What is credentialing?
Credentialing is the process of reviewing, verifying, and periodically re-verifying practitioner and/or organization credentials in accordance with defined criteria.
What does the credentialing process include?
The credentialing process includes three primary steps:
- Application review. We confirm you have fully completed the application and supplied all required supporting documents.
- Credentials verification. We verify information including, but not limited to, license status, insurance coverage, and education/training using criteria defined to meet accreditation, regulatory, and other applicable requirements.
- Committee review. If credentials meet minimum standards, the application is sent to a Regional Network and Credentialing Committee (RNCC) comprising Magellan Complete Care of Virginia clinical staff and professional peers. The RNCC reviews applications subject to business needs and in accordance with applicable state law.
How long does the credentialing process take?
Once all required documents have been submitted, credentialing and contract execution/activation can occur. Magellan Complete Care of Virginia completes the process over 90% of the time within 60 days after receipt of all necessary information.
Do you have additional questions?
See our Provider FAQ.
Ready to join our network?
STEP 1: Complete one of our Interested Provider Forms.
- Individual Practitioners and/or Group Practices
If you are an individual practitioner, physician group or a group of provider who provide medical services, please complete and submit the Provider Information Form.
- Group practices must fill out one Provider Information Form for the group and one Provider Information Form for each licensed practitioner in the group.
- Groups with over 50 practitioners, can submit one Provider Information Form for the group and a Roster listing each practitioner in the group. The Roster must include the following information: practitioners name, degree type, individual NPI, CAQH#, DOB, and type of provider.
- Group practices that employ nurse practitioners must complete a Provider Information Form for each nurse practitioner along with an Advanced Nurse Practitioners Attestation.
- Organization/Facility Providers
If you are licensed by the Commonwealth of Virginia to provide services as a facility or an organization (this includes DME providers), please complete and submit the Organization Provider Application.
- Complete the Organization Provider Application for the primary site and complete a separate Organization Application Supplement form (included in the application) for each of additional service locations.
- Individual Service Facilitators
Are you an individual provider that is licensed by the Commonwealth of Virginia to provide long-term support or ancillary services? If so, please complete and submit the Individual Service Facilitator Application along with a Site and Services form.
STEP 2: Submit your Interested Provider Form along with a IRS Tax Form_W9 to our Network Team.
Use one of the three ways below to submit your interested provider application along with an IRS Tax Form W-9 to the Network team. All submissions must include the name of a Primary Contact person along with an email address and/or phone number.
- Fax: 888-656-5098
- Email: VAMLTSSProvider@Magellanhealth.com
- US Mail: Magellan Healthcare
Attn: Network Department
3829 Gaskins Road
Richmond, VA 23233
STEP 3: A Network representative will review your initial application and will contact you within 7 – 10 business days with your next steps in the process.
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