Select State
line top nav icon pharmacy Find a Pharmacy line top Nav icon provider Find a Provider line top nav icon Hospital Find a Hospital line top nav icon login Web Portal line top nav Home Home line top nav

Button About Molina
Button Members
Button Providers
  Molina Healthcare Home   Logo line    Logo Your Extended Familys
Font size 11 Font size 12 Font Size 13 Font Size 14
 
 
 
Button find march vision providers 
Button Facility Review 
 
manual
forms
policies
HIPAA
EDI
drug list
health resources
communications
contact us

EDI Enrollment Forms


ERA/EFT Enrollment

Molina Healthcare is proud to announce that on July 25, 2011, our EFT/835 process is being transitioned from our internal process to our existing payment vendor, FIS Global. To get registered for EFT/835s, please go to https://providernet.adminisource.com. If you have any questions regarding the actual registration process, please contact FIS/ProviderNet at (877) 389-1160 or email Provider.Services@fisglobal.com.

 

Icon PDF 278 EDI Enrollment Form

 

 

 

 

 

Icon PDF Adobe Acrobat Reader is required to view the file(s) above. Download a free version.

back