CommercialPrior AuthHigh impact
Mutual News Q4 2019 Newsletter
Medical Mutual of Ohio·OH·Mutual News Newsletter
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Summary
Medical Mutual is updating their network fee schedule effective April 1, 2020, and transitioning specialty drug prior authorizations to Magellan Rx Management effective January 1, 2020. J-codes and radiological materials will now be updated quarterly at 100% of Medicare rates, and specialty drug prior auths must be submitted through new Magellan channels.
Action Required
By January 1, 2020: Billing team must update prior authorization workflows for specialty drugs to use new Magellan Rx Management system - submit requests online at IH.MagellanRx.com, by fax at 1-888-656-1948, or by phone at 1-800-424-7698. By April 1, 2020: Access updated fee schedules through Medical Mutual Provider Portal at MedMutual.com/Provider for new reimbursement rates on J-codes and radiological materials.