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HIPAA TCS Readiness


Molina Healthcare would like you to understand what we have done to provide for a smooth transition to the HIPAA standards.

Molina Healthcare is ready to support the following HIPAA-compliant transactions:

  • 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

HIPAA Transactions Contingency Plan

Over the last several years, Molina Healthcare has worked diligently and collaboratively with the broader healthcare community to achieve compliance with the federal HIPAA transactions and codes sets (TCS) requirements. Molina Healthcare committed to working with provider organizations to facilitate a smooth migration to the HIPAA standards. Molina implemented a contingency plan on October 16, 2003 that allowed providers and other trading partners to temporarily continue to send electronic healthcare transactions in pre-HIPAA electronic formats.

Molina has discontinued its HIPAA inbound claims contingency plan. All electronic claims sent to Molina must comply with HIPAA standards.

Molina's contingency plan in still in effect for electronic encounters. If you are still using one of more pre-HIPAA electronic formats for encounter submissions, you are encouraged to transition to full usage of the HIPAA standards as soon as possible.

We look forward to working collaboratively with you to help facilitate your transition to HIPAA compliant transactions. 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 after October 13, 2003.