This is the Magellan website for behavioral health providers
Magellan Health

PROVIDER GRIEVANCE FORM

Directions: Use this form to communicate with Magellan of Virginia any grievance related to another Provider or Magellan. Please be as detailed as possible in your comments.  The areas of the form notated with a red asterisk are required.  The form cannot be submitted if those areas are blank.

Please use the “UPLOAD” or “Browse” button to attach any additional information that you believe is relevant to your grievance (e.g.: Claim Forms, Explanation of Benefit, Correspondence from Magellan, etc.).

COMPLAINTANT’S INFORMATION
GRIEVANCE DETAILS