Making Changes to Your Provider Agreement

To make changes to your provider agreement (contract) including but not limited to adding and/or removing covered services under your current Medicaid Agreement, please follow the steps listed below:

• Contact your Network Management Specialist to initiate the change to your contract.
• Sign and Return your Amendment to the correct address, as documented in the amendment materials.
  • Once your signed amendment is received, it will be executed with an effective date and a hard copy will be returned to you.
  • Please Note: You are not contracted to provide a service until you receive an executed amendment listing this service with your effective date. (Services provided prior to the effective date will not be reimbursed by Magellan.)

* IMPORTANT NOTE: As per section 3.2 of the Medicaid Addendum to Magellan Behavioral Health, Inc. Provider Agreement:

3.2 Payment for Covered Services. Subject to the terms and conditions set forth in the Agreement, Magellan Policies and Procedures and this Medicaid Addendum, Magellan shall compensate Provider for authorized Covered Services provided to Enrollees in accordance with the reimbursement schedule specified in Exhibit B to this Medicaid Addendum.