The Availity Essentials portal provides access to all portal functions.Register here
We're glad you're part of the Molina Family
Provider Portal - Direct Access Removal
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 COVID-19
Molina has gone green, and is requesting that all providers submit provider dispute and appeals electronically. Electronic submission provides benefits to providers including faster disputes and appeals processing, increased overall efficiencies, improved processing accuracy and reduced HIPAA violations.
Any disagreement regarding the processing, payment or non-payment of a claim is considered a provider dispute. Provider disputes are typically disputes related to overpayment, underpayments, untimely filing, missing documents (i.e. consent forms, primary carrier explanation of benefits) and bundling issues. Provider Appeals are requests related to a denial of an authorization or medical criteria. A provider has 90 days from date of remittance denial to dispute a claim.
Molina offers the following submission options:
PsychHub is an online plaform for digital mental health education. Molina Providers are able to access PsychHub online learning courses through their Learning Hub for FREE. Contact your local Molina provider services team.Read More PsychHub
View the states, counties, and communities we serve
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