Need a Prior Authorization?
PA Lookup tool is under maintenance.
Please refer to the state specific Excel matrix while the PA Lookup Tool is disabled.
Welcome Molina Healthcare of Nebraska Providers
Contracted providers are an essential part of delivering quality care to our members. We value our partnership and appreciate the family-like relationship that you pass on to our members.
As our partner, assisting you is one of our highest priorities. We welcome your feedback and look forward to supporting all your efforts to provide quality care.
If you have any questions, please call Provider Services at (844) 782-2678 from 7 a.m. to 6 p.m. CT, Monday to Friday.
New P2P Scheduling Tool
Need a Peer-To-Peer review for your Molina Medicaid patient? Put in a request with our convenient new scheduling tool. CLICK HERE.
What's New/ Recent Updates
It is important to Molina Healthcare and your patients that your provider directory demographics are accurate. The State of Nebraska’s Department of Health and Human Services (NE DHHS) assigns a Provider Medicaid ID number to each Provider address. The Provider Medicaid ID number/ address/ NPI combination along with the Group NPI and Tax ID on file with Molina, must match the information that is on file with NE DHHS for claim payment; therefore, all changes should be made through the NE DHHS website.
For more information CLICK HERE.
NOTICE: End of the Continuity of Care Period for Prior Authorizations (PA)
Effective March 31st, 2024, the Continuity of Care Period ends for Molina’s entry into the market.
Effective April 1st, 2024, Molina will be enforcing Prior Authorization (PA) requirements as follows:
All PAR and Non-PAR Providers must submit a PA request for services included on the PA Look-Up Tool prior to services being rendered.
All NON-PAR providers are required to submit a prior authorization for ALL services beginning 5/1/24.
Molina does not perform retrospective reviews. Failure to obtain PA prior to services rendered may result in denial of the claim (limited exceptions).
The Prior Authorization Look-up Tool on this website is your source of truth for services requiring a prior authorization.
Nebraska - CyncHealth
Heritage Health is dedicated to improving the health and quality of life of our members and actively supports the statewide implementation of the Nebraska Health Information Exchange (HIE). The HIE is the secure electronic information infrastructure for sharing health information among health care organizations and offers health care providers the functionality to support meaningful use and a high level of patient-centered care.
Heritage Health encourages Providers to connect to the HIE through various communication channels such as annual workshops, routine onsite visits, and general provider relations interaction.
HIE is a secure, interoperable network which participating providers with certified electronic health record (EHR) technology can use to locate and share needed patient information with each other which results in improved coordination of care among physician practices, hospitals, labs, and across the various health systems. Sharing data through the HIE helps to reduce administrative costs in printing health records or required documents with other Providers and Payors.
We encourage you to visit CyncHealth - Home to obtain more information about the program
Important Provider Notices
Standby for some important provider information!
Your Opinion Matters
Email us to share your comments, concerns, or ideas Your feedback is important to us. Let us know what we’re doing well and what we can do to improve.