As our health care partner, it’s important that you have all the latest information about Molina’s operations. Please click the Provider Communication links below for up-to-the-minute details about Molina’s key plan updates, legislative changes, industry trends and news, upcoming meetings, training opportunities, and emergent issues in the industry.Provider Newsletters Communications & Important Reminders Resources & Training COVID-19
It is important to Molina Healthcare and your patients that your provider directory demographics are accurate. Please visit our Provider Online Directory to validate your information and notify us if there are any updates.
Please notify Molina Healthcare at least 30 days in advance when you have any of the following:
For providers seeking to appeal to denied Prior Authorization (PA) on behalf of a member only, fax Member Appeals at (844) 808-2407.
For providers seeking to appeal a denied claim only, fax Provider Claim Disputes/Appeals at (844) 808-2409.
If a provider rendered services without getting an approved PA first, providers must submit the claim and wait for a decision on the claim first before submitting a dispute/appeal to Molina.
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Quality Improvement | HEDIS | CAHPS | Culturally and Linguistically Appropriate Resources | Clinical Practice Guidelines | Preventive Health Guidelines | Health Management | Integrated Case Management | Molina’s 24 Hour Nurse Advice Line | Opioid Safety Resources | Utilization Management | HEDIS/CAHPS Tip Sheets | Provider Education Series
EDI | ERA/EFT
HIPAA Transactions | HIPAA Code Sets | Unique Identifiers | Privacy of Health Info | HIPAA Security | Contact HIPAA
Drug Formulary | Medication Prior Authorization Criteria and Clinical Policies | Physician Administered Preferred Drug List
Member Rights and Responsibilities | Fraud Prevention Tips | Reimbursement Policies