Magellan Complete Care of Virginia (HMO SNP) is a Medicare Advantage health plan that helps members maintain health and wellness within their own homes and communities. Magellan has decades of experience with improving the health of individuals through managing specialized services including pharmacy, specialty solutions and behavioral health.
We have a reputation for delivering access to high-quality care and helping our members get the most from the benefits we offer. One of the reasons we can do that is because we partner with the very best providers. We’re proud to work with healthcare professionals who share our commitment to serving our dual-eligible special needs population.
Magellan Complete Care of Virginia (HMO SNP) makes it easy for you to focus on your patients by:
- Saving you time
– Simplified credentialing
– Easy claims submission
– Prompt payments
- Giving you access
– To free online provider education resources
– 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
- Recognizing you as our partner
– In our innovative Model of Care, which provides a team approach to healthcare
– In quality improvement programs that improve our processes
When you join the Magellan Complete Care of Virginia (HMO SNP) network of providers, you get a collaborative, team-based approach to health care. To join us, individual providers, group practices and organizations must be contracted and credentialed with Medicare and MCC of VA (HMO SNP).
How to Join Our Network
- Download instructions and enrollment form here
- Visit the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) to securely and electronically submit and manage Medicare enrollment information
- For questions, phone us at 1-800-424-4495 or email us at MCCVAProvider@MagellanHealth.com
- You can also email CMS at firstname.lastname@example.org
- Individual Practitioners and/or Medical Groups
- If you are an individual practitioner or a medical group who provides medical services, please complete and submit the Provider Information Form.
- Group practices must complete one form for the group and one form for each licensed practitioner in the group.
- Groups with over 50 practitioners can submit one form for the group, the Provider Roster Form, listing each practitioner in the group. The roster must include the following information: practitioner name, degree type, individual NPI, CAQH#, DOB, and type of provider.
- Organization and 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 this application for the primary site and complete a separate Organization Application Supplement form (included in the application) for each additional service location.
- What is credentialing?
Credentialing is the process of reviewing, verifying and periodically reverifying provider and/or organization credentials in accordance with defined criteria. Prior to contract execution, we ensure providers and organizations meet credentialing criteria and are approved by the Peer Review Credentialing Committee (PRCC).
- What does the credentialing process include?
The credentialing process includes these primary steps:
1. Application. If you are not yet accredited for participation in our plan, complete and submit the Provider Data Form for Credentialing.
2. Application review. We confirm you have fully completed the application and supplied all required supporting documents.
3. 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.
4. Committee review. The Peer Review Credentialing Committee (PRCC), comprised of Magellan Complete Care of Virginia (HMO SNP) clinical staff and professional peers, reviews applications subject to business needs and in accordance with applicable state law.
- How long does the credentialing process take?
Magellan will complete the credentialing process in a manner that is, at a minimum, within required federal and/or state timeframes. If needed, we’ll reach out to providers for missing information required to complete credentialing. For questions about credentialing status, please contact us at MCCVAProvider@magellanhealth.com.
You may submit your form(s) and W-9 in one of 3 ways:
MCC of VA (HMO SNP)
Attn: Network Department
3829 Gaskins Road
Richmond, VA 23233