For nearly a decade, Molina Healthcare has worked diligently and collaboratively with the broader healthcare community to achieve compliance with the federal HIPAA transactions and code sets (TCS) requirements. Molina Healthcare would like you to understand our HIPAA TCS readiness.
HIPAA 4010 Transaction Readiness
Molina Healthcare is ready to conduct the following HIPAA 4010A1 transactions with providers:
- 837 Claims (Professional and Institutional)
- 837 Encounters
- 270/271 Eligibility Status Inquiries and Responses
- 276/277 Claims Status Inquiries and Responses
- 835 Electronic Remittance Advice
- 278 Service Request Review and Response
HIPAA 5010 Transactions Readiness
On January 16, 2009, the Secretary of Health and Human Services published modifications to the HIPAA transactions standards by adopting the ASCX12 Version 5010 for covered transactions conducted on or after January 1, 2012. Please note that during the period March 17, 2009 through December 31, 2011, use of both X12 4010A1 and 5010 versions of the HIPAA transactions are permitted by the Secretary.
Molina Healthcare is committed to working with provider organizations to facilitate a smooth transition to the 5010 transactions standards. Molina Healthcare is ready to test the 5010 versions of the HIPAA transactions with providers and other trading partners. Learn additional details regarding Molina Healthcare's 5010 readiness and migration plan.
HIPAA TCS Questions
For HIPAA TCS questions or concerns, please call our toll-free HIPAA Provider Hotline at 1-866-MOLINA2 (1-866-665-4622).
IMPORTANT NOTE: HIPAA does not require health care providers to conduct claims or other transactions electronically with Molina Healthcare. For example, if you currently submit claims to Molina Healthcare using paper, you may continue to do so.