Magellan Health

For Providers

Ordering/Referring/ Prescribing (ORP)

Ordering, referring and prescribing is an initiative to comply with program integrity provisions of the Affordable Care Act (ACA) which states that the State Medicaid agency must require all ordering or referring physicians or other professionals providing services under the State plan to enroll as participating providers effective January 1, 2018.


To ensure your compliance and ensure that your services are eligible for reimbursement please review the below documents that provide guidance on where to include ORP information on different types of claim forms. Document A outlines the state Provider Types (PT) and Specialty Codes (SP) that require ORP information on claims starting January 1, 2018. After your PT and SP is determined, please visit the State website for corresponding billing instructions.


Helpful Resources

 
Providers who need to enroll should visit – www.dhs.pa.gov/provider/promise/enrollmentinformation/index.htm

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Recovery & Resiliency

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Contact Information

Member Services:
Bucks County: 877-769-9784
Cambria County: 800-424-0485
Delaware County: 888-207-2911
Lehigh County: 866-238-2311
Montgomery County: 877-769-9782
Northampton County: 866-238-2312

Provider Services:
Bucks/Montgomery: 877-769-9779
Cambria County: 800-424-3711
Delaware County: 800-686-1356
Lehigh/Northampton: 866-780-3368

Hearing Impaired Lines (TTY):
Bucks County TTY: 877-769-9785
Cambria County TTY: 877-769-9785
Delaware County TTY: 888-207-2910
Montgomery County TTY: 877-769-9783
Lehigh County TTY: 866-238-2313
Northampton County TTY: 866-780-3367
AfterHours TTY (6:00p - 8:00a): 800-787-1730

Fraud & Abuse: 800-755-0850

For emergency situations always call 911

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