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 at: providersearch.molinahealthcare.com 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