Customer Service Telephone Numbers for Providers and Recipients:

Check status of review requests Monday through Friday (except holidays) 8:00 am – 5:00 pm

(505) 348-0311 (Albuquerque local)

(866) 916-3250 (outside of Albuquerque toll-free)

Utilization Management:

Telephone requests Monday through Friday (except holidays) 8:00 am – 5:00 pm

(505) 348-0311 (Albuquerque local)

(866) 916-3250 (outside of Albuquerque toll-free)

Fax requests (all toll-free) available 24 hours a day, seven days a week:

(866) 553-9268

(866) 553-9272

(866) 553-9359

*An automated sort distribution system is used to ensure that faxes are routed to the correct department and reviewer.

Mail requests:

Molina Healthcare of New Mexico – Third Party Assessor

PO Box 3909

Albuquerque, NM  87190

Provider Re-review and Reconsideration Process

Providers who disagree with review decisions must request a re-review before requesting a reconsideration. Molina Healthcare TPA has 15 days from receipt of the written request to complete the review of the re-review request. Providers who disagree with a re-review determination may request a reconsideration. Molina Healthcare TPA has 30 days from receipt of the written request to complete the review of the reconsideration request.

Additional details regarding telephone re-review and reconsideration requests can be found at the following link:

http://www.hsd.state.nm.us/mad/pdf_files/provmanl/prov953.PDF