MagnaCare Customer Service: an expert operational guide

MagnaCare is a national network-management and third-party administrator that supports employer-sponsored health plans, brokers, providers and members. For any interaction with MagnaCare customer service, the single authoritative online resource is https://www.magnacare.com, where you can access member portals, provider directories and plan documents. This guide explains how to contact MagnaCare, what information to prepare, common issues and proven escalation strategies so you get predictable, auditable outcomes.

Below you will find practical, procedure-focused details — what to expect during a call or secure message, the documents and identifiers that accelerate resolution, and provider-specific steps for credentialing and claims follow-up. The language is intentionally procedural so you can use it as a checklist when you are on the phone or composing written appeals.

How to contact MagnaCare quickly and efficiently

The primary, verifiable channel for all members and providers is the MagnaCare website (https://www.magnacare.com). On the site you will locate the correct phone numbers, secure member login, and provider resources; these numbers vary by plan sponsor and state, so the fastest route is to use the phone number printed on the back of your member ID card or the “Contact Us” page. When you call, ask the representative for a reference or confirmation number and the employee ID/name handling your case — record that information immediately.

Use the member portal or secure messaging for non-urgent requests (eligibility confirmations, printed ID requests, explanation of benefits). Secure messages create ticket records and timestamps that are helpful for escalations and appeals. If you are a provider, enroll in the provider portal and EDI services to receive real-time claim acknowledgements and remittance advice; those electronic channels reduce follow-up time by 40–70% compared with paper correspondence.

Before you call or submit a ticket, have these items ready: the member ID number, group number, date(s) of service, provider NPI and taxonomy, claim number (if one exists), ICD/CPT codes in dispute, and copies of the Explanation of Benefits (EOB). Having those items reduces hold time and the need for callbacks; in practice, it shortens average handling time by multiple minutes and avoids repeated documentation requests.

Common inquiries and how to resolve them fast

Most inbound requests to MagnaCare customer service fall into a small set of categories: eligibility/coverage verification, pre-authorization, claim status or payment, network provider search, and appeals/denials. For each category, there are standard documents and immediate actions that lead to a resolution in a single contact.

• Eligibility & Coverage: Provide member ID, group number, and the exact date of service. Ask for “coverage determination” and request a written confirmation or portal message for audit trail.
• Pre-authorization: Supply diagnosis, planned CPT codes and supporting clinical notes. Record the pre-auth or referral number and expiration date; verify whether the authorization is for inpatient days or a single procedure.
• Claim status: Provide claim ID, DOS, billed amount and tax ID/EIN of the provider. If the claim is in “pending” status, request the specific missing documentation and a deadline for submission.
• Network & Referrals: Request the provider’s participation status, in/out-of-network reimbursement policy and any applicable employer carve-outs or site-of-service edits.
• Appeals & Grievances: Ask for the formal appeal form or submission endpoint, typical timelines, and the name/contact of the appeals coordinator.

Claims, billing and appeals — operational details

When pursuing a claim or rebutting a denial, create a claim packet that includes the original claim, itemized bill, EOB, relevant medical records, and a concise cover letter that lists the exact remedy you seek (payment in full, reconsideration of medical necessity, waiver of cost-share, etc.). Submit the packet through the provider portal or via the plan’s stated submission channel and obtain a timestamped confirmation. If you must mail documents, send them via tracked courier and retain proof of delivery.

Expect timelines to vary by sponsor contract, but common operational practice is to adjudicate clean claims within several weeks and to allow at least one internal appeal step for denials. If an appeal is required, include objective clinical evidence (peer-reviewed guidelines, consult notes) and explain why the requested service meets coverage criteria. Always request an estimated completion date and escalate if that date lapses without status updates.

Provider support, credentialing and contracting

Providers should register with MagnaCare’s provider relations team through the online portal and typically must complete an onboarding packet that includes W-9/EIN, WCB (if applicable), NPI, copy of state licenses, malpractice declarations and CAQH or equivalent attestation. Typical credentialing windows range from 45 to 90 days for routine applicants; plan-specific expedited review may be available for high-volume specialties or network gaps.

• Provider onboarding checklist: W-9, NPI, taxonomy, copy of state license, malpractice insurance declarations (limits and policy number), roster of practitioners, and CAQH attestation or similar credentialing profile.

Escalation paths, complaints and regulatory options

If front-line customer service cannot resolve your issue, ask for escalation to a supervisor and request the supervisor’s direct contact information. Keep a written log of every interaction (date, time, representative, reference number, summary). For unresolved grievances, MagnaCare plans typically publish a formal grievance/appeal submission procedure; use that procedure and include your interaction log to substantiate any service-level or communication failures.

If you exhaust the plan’s internal processes without satisfactory resolution, you may pursue external review through your state’s Department of Insurance or an independent external review organization. Consult your plan’s Summary Plan Description (SPD) and Evidence of Coverage (EOC) for deadlines and external review eligibility; those documents also list the state regulatory contact or provide links to the appropriate DOI web page. For immediate guidance, the MagnaCare website’s “Contact Us” area points to plan-specific appeal addresses and requirements.

Is MagnaCare an insurance company?

MagnaCare Insurance Health Plans
MagnaCare offers customizable health plans, including: Self-funded health plans.

Does MagnaCare have dental?

We have a wide range of dental health plans. We focus on affordable plan designs from broad PPO or HMO networks, so everyone has something to smile about. When our company moved away from our large insurance carrier, MagnaCare created a self-funded plan that was just right for us.

What is the phone number for ehealth customer service?

1-877-751-9310
Our customer care center is staffed with licensed health insurance agents and knowledgeable representatives, ready to assist you. Our licensed insurance agents and knowledgeable representatives are ready to help you. Just call 1-877-751-9310 Mon – Fri, 10AM – 7PM ET. Sat – Sun, Closed.

How do you verify insurance eligibility?

Contact insurance providers: Use online portals or call centers to confirm active coverage, co-pays, deductibles and out-of-pocket limits. Validate policy specifics: Check for pre-authorizations, co-insurance requirements and coverage for specific procedures.

How to verify MagnaCare eligibility?

Eligibility and Benefits
To check the eligibility for a Create member, log into your account at Provider Portal and navigate to ELIGIBILITY & BENEFITS. Use the Member ID to search for member eligibility. For more information, call our Provider Services team at 1.844. 427.3878 Monday to Friday, 8:30 am to 6:00 pm ET.

How do I contact MagnaCare?

800.352.6465
Our Provider customer service can assist you with that. Please call 800.352. 6465.