Magellan Rx, administered by Magellan Rx Management, reviews and approves prior authorization requests for select specialty drugs that fall under the medical benefit and select oncology drugs that fall under the pharmacy benefit.
In addition to providing prior authorization, Magellan will review claims for:
- Medical necessity
- Accurate claims submission that is consistent with treatment protocol
- Appropriateness of use (e.g. prescribing in accordance to FDA labeling)
Providers are required to contact Magellan Rx to obtain prior authorizations for the following lines of business:
- Medicaid (including Child Health Plus)
- Medicare Advantage
Important to note
- This online portal is for non-urgent requests only. Call Magellan Rx directly for urgent requests at 1-800-424-8231.
- View the list of drugs associated with this program.
- Our self-funded line of business is not required to use Magellan Rx for prior authorizations.
- Submit requests at your convenience.
- Info gathered from questionnaires facilitates a simpler and faster authorization process.
- Receive clear confirmation that the request was submitted, complete with tracking information for requests that need additional review.
- Less paperwork with online submission, while still being able to submit clinical support documents.
How to get started
Initial setup requires both an Independent Health Provider Portal account and a Magellan Rx account. Magellan Rx is located on the Portal’s Authorization Hub. You will need either a Practice Admin Full Access or Authorization role to access this Hub.
Once logged in the provider portal users navigate to the Authorization Hub and select the launch button for Specialty Medication Authorization. If users have a Magellan Rx Account for Independent Health, they can sign in by entering their username and password.
Review instructions for setting up a Magellan Rx Account.
Please contact the Independent Health’s Provider Relations Department by phone at (716) 631-3282 or 1-800-736-5771 Monday through Friday from 8 a.m. to 6 p.m. or email email@example.com.