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Provider Grievances

Issue Escalation and Resolution

Escalation of Issues:

Providers should seek resolution with Magellan Health, Inc., using the two tier process that has been developed for escalation and resolution. This process is in place for both in-network and out-of-network providers to dispute Magellan’s policies, procedures, or any aspect of Magellan’s administrative functions.

Magellan strongly recommends that providers document the name of the representative(s) with whom they speak or communicate along with the time and date and provide that information as issues are escalated. Note that if e-mailing protected health information to the Health Plan (or DHH), providers should use secure e-mail. Magellan is required to submit a monthly report of all provider grievances to DHH including the issue in the grievance. These reports are closely monitored by DHH for trends and matters that may require corrective action by Magellan.

Two Tier Process for Escalating Issues:

  • Tier 1 Escalation – Provider Relations Liaison Level 

Contact your Provider Relations Liaison by phone or email, or by calling the toll-free provider line at 1-800-424-4489.

  • Tier 2 Escalation – Executive Leadership Level

Gail Fowler
Lead Network Project Manager
IGFowler@magellanhealth.com
314-387-5827

Subscribe to our Provider Updates 

Magellan often posts provider updates, news and announcements to address systemic or trending provider issues. Providers can subscribe to Provider Updates from Magellan.

Contact LA - DHH - Office of Behavioral Health

If a provider is unable to reach satisfactory resolution or get a timely response through the Magellan escalation process, direct contact with DHH should be the final step.

  • E-mail DHH staff using the online form on the DHH-LA Behavioral Health Partnership (LBHP) website -
    • Select the Provider Grievance Escalation option from the right side menu bar.
    • Be sure to include details on attempts to resolve the issue at the Health Plan level as well as contact information (contact name, provider name, e-mail and phone number) so that Office of Behavioral Health staff can follow up with any questions.
  • Your inquiry or grievance will be immediately emailed to OBH staff for a response. You will be contacted for additional information or documentation as needed to come to a resolution.




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