17 Oct, 2018 → by ClaimboUser502918
Denial of claims

Multiple bad experiences with them. This insurance is via my employer. My health insurance is excellent, but they use Magellan for mental health and it has been HORRENDOUS. With one sick child who needed services, they denied the providers claims, stating that they did not receive them. we had to mail the claims in by commercial carrier such that they could not deny receipt, then they started paying. They find reasons to deny. If you don't submit within what they consider timely filing, you don't get paid. Filing an appeal is worthless. It is simply denied by them with no outside oversight. Now i have claims for counseling myself, which are of course from outside of their network, because no good providers will work with them. The initial claim was paid but now they are denying subsequent visits for which they write "no subsequent initial evaluation has been authorized." Here goes the fight again. Lots of luck talking to anyone at Magellan who knows anything. Last time i had to go all the way up the chain to a regional supervisor who refused to answer my calls or emails, nor those of the the provider. I complained to my employer, but of course no action. They too love saving money at the employee's expense.
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